Location: New Haven, CT
Cap-Exempt H-1B Position — No lottery required
Working at Yale means contributing to a better tomorrow. Whether you are a current resident of our New Haven-based community, eligible for opportunities through the New Haven Hiring Initiative, or a newcomer, interested in exploring all that Yale has to offer, your talents and contributions are welcome. Discover your opportunities at Yale! Under the direction and supervision of the Associate Director and Team Lead/Manager, employee will be responsible for insurance follow-up on carrier denials with a focus on coding denials for Yale Medicine. Employee will also function as a liaison in the day to day follow-up of denied and no response claims to obtain maximum reimbursement for services rendered by Yale Medicine and other related practices. Follow up of denied and appealed claims for Yale Medicine and its related specialties and practices. Follow up of provider ineligible denials according to the rejection code posted in Epic and follow process guidelines established by the Central Business Office management team. Follow up of coding denials according to the rejection code posted in Epic and follow process guidelines established by the Central Business Office management team. Process and review carrier denials for adherence to specific payer Explanation of Benefits. Knowledge of appealing denials in order to receive maximum reimbursement for Yale Medicine. Write, send and follow up on appeals as appropriate by contacting the carrier, researching carrier policies, review of medical documentation and/or work collaboratively with YM staff to ensure maximum reimbursement. Directly communicate with third party insurance carriers, patients, and other listed payers in order to investigate payment/reimbursement delays for billed charges, for both primary and secondary claims. Respond to requests from insurance carriers, Yale Medicine clinical departments and/or patients for supporting documentation necessary in order to obtain maximum reimbursement. Work closely with other