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Denial Process Representative

New Jersey
Job Type
14 Jul 2022
Position #: 2005

Analyzes all patient accounts denied of correct payment by Managed Care Payors and works with proper departments to ensure payments and collections of money owed to Capital Health (CH).
  • Instructs and assists co-workers to identify and organize data relating to incorrect payments or denials for reconciliation and appeals.
  • Frequently receives, provides, clarifies or exchanges information with Managers/Directors within department. Has frequent interaction with Case Management, Quality Resource Management, Patient Access, and Patient Accounts.
  • Coordinates and attends denial work sessions with other hospital departments directly involved with denials process.
  • Utilizes Denial Management software to monitor and review monthly trends prior to report distribution.
  • Downloads and manipulates excel spreadsheets from Denial Management software to be distributed to various CH departments in order to identify denial patterns, trends, and issues.
  • High School Diploma or GED.
  • One year of related work experience.
Frequent physical demands include: Sitting

Occasional physical demands include: Standing , Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion

Continuous physical demands include:

Lifting Floor to Waist 20 lbs. Lifting Waist Level and Above 10 lbs.

Offers are contingent upon successful completion of our onboarding process and pre-employment physical. Furthermore, Capital Health is a mandatory Influenza and Covid-19 vaccination facility.

Capital Health will never ask candidates for social security numbers or date of birth during the application phase. If you are asked for this information online, you may be a target for identity theft.

Department: Patient Billing/Credit

Shift: Day

External Company URL:

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  • Job Reference: 658140381-2
  • Date Posted: 14 July 2022
  • Recruiter: Capital Health
  • Location: New Jersey
  • Salary: On Application
  • Sector: Insurance & Superannuation
  • Job Type: Permanent