Denial Specialist (HYBRID), Day Shift, Patient Financial Services

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If you are a current Adventist HealthCare employee, please click this link to apply through your Workday account.

 

Adventist HealthCare seeks to hire an experienced Denial Specialist who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing.

As a Denial Specialist, you will:
• The Denials Specialist determines the root cause of denial or partially paid claim.
• Files appeal after review of a denial indicates an appeal is needed or the payer agrees to reprocess the claim.
• Requests rebill/corrections if denial has been reviewed and it is determined that a rebill is needed.
• Contact the payer either by phone call or online payer portal if determined that a denial was inappropriate or additional information is needed for adjudication.
• Routes denial to the appropriate team after a denial has been determined that another department should resolve.
• Routes claim to biller only when no claim is on file after review of the bill scrubber acceptance report.
• Transfers unpaid balance to a patient once patient responsibility has been determined.
• Review the Explanation of Benefits for clarity.
• Processes payer changes as needed.

Qualifications include:
• High School Diploma required, or some college preferred.
• A minimum of 3 years experience within a healthcare environment can include an insurance company, public health setting, or an outsourcing company.

Work Schedule:

Day Shift- Hybrid

Work Hours: 8 am - 4:30 pm or 8:30 am - 5:00 pm

#GR8 Accounting & Finance

At Adventist HealthCare our job is to care for you.

We do this by offering:

• Work life balance through nonrotating shifts

• Recognition and rewards for professional expertise

• 403(b) retirement plan

• Free Employee parking

• Benefits Eligible Positions:

  • Competitive, comprehensive benefit plans [including health, employer-paid disability and life insurance, PTO]

  • Employer retirement contribution and match after 1-year of eligible employment with 3 year vesting  

  • Ancillary benefits such as flexible spending, legal and pet insurance to meet the needs of employees and their eligible family members

  • Subsidized childcare at participating childcare centers

As a faith-based organization, with over a century of caring for the communities in the Maryland area, Adventist HealthCare has earned a reputation for high-quality, compassionate care. Adventist HealthCare was the first and is the largest healthcare provider in Montgomery County.

If you want to make a difference in someone’s life every day, consider a position with a team of professionals who are doing just that, making a difference.

Join the Adventist HealthCare team today, apply now to be considered!

COVID-19 Vaccination

Adventist HealthCare strongly recommends all applicants to be fully vaccinated for COVID-19 before commencing employment. Applicants may be required to furnish proof of vaccination.

Tobacco and Drug Statement

Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine and drug use.

 

While some jurisdictions, including Maryland, permit the use of marijuana for medical purposes, marijuana continues to be classified as an illegal drug under the federal Controlled Substances Act.  As a result, medical marijuana use will not be accepted as a valid explanation for a positive drug test result.

 

Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine) and marijuana. Those testing positive are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing. ("Nicotine products" include, but are not limited to: cigarettes, cigars, pipes, chewing tobacco, e-cigarettes, vaping products, hookah, and nicotine replacement products (e.g., nicotine gum, nicotine patches, nicotine lozenges, etc.).

Equal Employment Opportunity
Adventist HealthCare is an Equal Opportunity/Affirmative Action Employe