Healthcare Claims Denials Specialist

Become a part of our caring community and help us put health first

As an Accounts Receivable Specialist / Healthcare Claims Denials Specialist , you will :

Ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.

Research, resolve, and prepare claims that have not passed the payer edits daily.

Determine and initiate action to resolve rejected invoices.

Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances.

Clear payment variances, resolving differences, and initiating corrective action.

Guide / instruct and support agency personnel encompassing all aspects of insurance and non-Medicare claims processing.

Prepare input data forms to update computer system.

Review and communicate with agencies to educate them about expectations for clean claims.

Use your skills to make an impact

Required Qualifications

High School Diploma or the equivalent

Minimum of two years medical claims processing experience

Knowledge of healthcare collection procedures and microcomputer software / hardware

Effective analytical and communication skills

Scheduled Weekly Hours

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting.

The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$37,200 - $51,200 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, Humana ) offers competitive benefits that support whole-person well-being.

Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.

Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About CenterWell Home Health : CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization.

Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.

About CenterWell, a Humana company : CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients.

As part of Humana Inc. (NYSE : HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career.

We proudly employ more than 30,000 clinicians who are committed to putting health first for our teammates, patients, communities and company.

By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status.

It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements.

This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion.

We also provide free language interpreter services. See our full accessibility rights information and language options