Clinical Denial Specialist

Job Summary

A company is looking for a Clinical Denial Specialist to manage claims and documentation in a healthcare setting.

Key Responsibilities

• Follow up on pending authorizations and denied claims; assist in appeals when necessary
• Collaborate with clinical staff and revenue cycle teams to ensure accurate records and compliance
• Update and maintain data in electronic health records (EHR) and generate reports on claim status

Required Qualifications

• High school diploma or equivalent; medical assistant certification preferred
• Minimum 3+ years of experience in healthcare administration, insurance verification, or medical billing
• Knowledge of medical terminology, CPT/ICD coding, and payer authorization processes
• Proficiency in EHR systems and insurance portals
• Strong organizational skills