Job Closed
This listing is no longer active.
Headquartered in Rochester, Minnesota, Mayo Clinic is a nonprofit medical institution ranked first in more specialties than all other hospitals in America. The
Denials Recovery Rep-Remote
Location
United States
Posted
94 days ago
Salary
$22 - $34 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Denials Recovery Rep-Remote
Mayo Clinic
The denials recovery representative is an experienced position within the Mayo Clinic enterprise denials management team. This position is responsible for investigating and resolving denied payments from third party payers in an effort to prevent lost reimbursement. The position will require experience in successfully appealing denials, including root cause analysis and coordination with payers to enable proper claim adjudication. The ability to effectively communicate with third party payer representatives and knowledge of appeal guidelines will be vital to the role. This position will be responsible for working denials of higher complexity, and will require knowledge of payer appeal requirements. This role will require adherence to quality assurance metrics, as well productivity standards that will enable denial key performance indicators to be met. Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. Benefits Highlights - Medical: Multiple plan options. - Dental: Delta Dental or reimbursement account for flexible coverage. - Vision: Affordable plan with national network. - Pre-Tax Savings: HSA and FSAs for eligible expenses. - Retirement: Competitive retirement package to secure your future. Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. Equal Opportunity All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law". Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
Benefits
- Medical: Multiple plan options.
- Dental: Delta Dental or reimbursement account for flexible coverage.
- Vision: Affordable plan with national network.
- Pre-Tax Savings: HSA and FSAs for eligible expenses.
- Retirement: Competitive retirement package to secure your future.
Related Guides
Related Categories
Related Job Pages
More Claims Specialist Jobs
• Investigating losses and identifying coverage issues • Obtaining and reviewing estimates, evidence, reports, and medical records • Handling First Party Damages • Handling Third Party Damages • Handling Total Loss, Fire, Theft and Glass Claims • Evaluating injury demands • Handing non repped and repped claims • Establishing damages and reserves • Processing payments • Taking recorded statements from insureds, claimants, and witnesses • Maintain claim file per best claim practice guidelines • Obtain and maintain all required state licenses
• The Auto Claims Casualty Adjuster is responsible for directing commercial automobile claim loss investigations and adjusting from a remote office setting. • Investigating losses (BI/UM/UIM primarily) from office, utilizing Independent Adjusters and other internal/external resources identifying coverage issues and completing coverage analysis. • Evaluation and valuation of injuries/damages. • Experience handling moderate to severe injury claims involving allegations of soft-tissue injuries, bone/cartilage fractures, disc herniations, joint dislocation, short-term hospitalizations and out-patient surgeries. • Handing attorney represented claimants (litigation claim-handling experience a plus). • Experience analyzing and responding to Time Limited Policy Demands. • Experience working with experts in multiple disciplines, including: physicians/therapists, attorneys, accountants, medical billing audit firms, accident reconstructionists, biomechanical engineers, forensic accountants. • Maintain claim files per established best claim practice guidelines. • Obtain and maintain all required state licenses.
• Directly handles business owner liability claims. • Analyze coverage issues under various standard industry forms. • Draft coverage letters and frequent communication with various parties including attorneys. • Manage an active desk of property damage and bodily injury liability claims under business owner policies. • Adjust total auto losses as part of adjusting liability claims. • Collaborate on setting reserves at appropriate level for claims. • Document claim files in accordance with established guidelines. • Obtain and maintain adjuster licenses as required.
• Manage an active desk of litigated and non-litigated claims of varying complexity under miscellaneous professional liability coverages • Recognize exposures and ensure reserves are adequate and timely • Evaluate coverage issues and identify risk transfer opportunities • Manage litigation by proper expert selection, planning, budgeting and partnership with defense counsel • Strong negotiation skills • Proactively manage claim resolution, including formation and implementation of resolution strategy, settlement valuation and obtaining settlement authority • Actively participate in mediations as needed, within limit of settlement authority • Manage allocated loss adjustment expense through strategic handling and bill review/payment processing in coordination with the billing unit • Appropriately document claim files in accordance with established guidelines • Maintain adjuster licenses, as required

