New

Patient Accounting Denials Specialist II-ABQ

Presbyterian Healthcare Services
life insurance
United States, New Mexico, Albuquerque
1100 Central Avenue Southeast (Show on map)
Jan 07, 2026
Location Address: 9521 San Mateo NE , Albuquerque, New Mexico 87113-2237, United States of America Compensation Pay Range: Minimum Offer $: 15.99 Maximum Offer for this position is up to $: 23.76 Now hiring a Patient Accounting Denials Specialist II-ABQ Summary: Responsible for root cause analysis and next step resolution of denials. Performs a variety of duties, including A/R follow-up, appeals, customer service, processing of correspondence, and daily reconciliation of activities. Type of Opportunity: Full time Job Exempt: No Job is based : Reverend Hugh Cooper Administrative Center Work Shift: Weekday Schedule Monday-Friday (United States of America) Responsibilities: * Performs denial follow-up activities for assigned payors utilizing work queues. * Submits corrected claims, reconsiderations and/or appeals to overturn denials. * Responsible for providing any information (medical records, itemized statements, etc.) requested by insurance companies to process claims and overturn denials. * Must follow process/procedures to ensure timely follow up on outstanding denials. * Document accounts in accordance with established PHS policies/procedures. * Knowledgeable in various computer systems (i.e. Electronic Health Record, claims clearinghouse, FISS/DDE, Payer portals, Microsoft Office Suite.) * Must utilize communication skills to be an effective team member. * Must actively participate in team meetings and take a proactive approach to communicate work related ideas and concerns. * Must develop and maintain professional work relationships with team members, PHS departments and outside agencies. * Maintains strictest confidentiality, adheres to all HIPAA and CMS compliance rules and regulations. * Perform other duties as assigned by the Denial Supervisor and/or Manager. * Responsible for root cause analysis and next step resolution of denials. * Performs denial follow-up activities for assigned payors utilizing work queues and various reports. * Reviews incoming denials to identify trends and perform root cause analysis to determine resolution to be implemented to prevent ongoing denials * Consult with lead regarding next steps with difficult claims Qualifications: High school degree or GED required, short-term training on insurance collections and claims processing. Minimum three years experience in insurance follow-up, billing, and collections. Demonstrated ability to communicate effectively via telephone and in writing and be computer literate. Must be passionate about contributing to an organization focused on continuously improving patient experiences and the health of our community. Experience with Microsoft Office Suite products required. Excellent organizational, problem-solving, verbal, and written communication skills, along with, attention to detail and the ability to interact effectively with other functional areas and management teams are required. Must have a strong work ethic and demonstrated ability to work effectively in a team environment. Basic knowledge of Coordination of benefits and the Medicare MSPQ preferred. Must have basic knowledge of various payer requirements, claim submission processes for major insurances carriers and intermediaries. Must have basic knowledge of the revenue cycle processes. Must be able to prioritize and manage a high-volume workload and be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements. All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more. Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. We're Determined to Support New Mexico's Well-Being \| Presbyterian Healthcare Services