Clinical Denials Specialist

Job Summary

Managing accounts receivable related to denied claims, the full-time Clinical Denials Specialist will investigate denials, follow up with insurance companies, and write non-clinical appeals while working remotely to ensure compliance with billing regulations.

Key responsibilities

• Accurately triage and route claims to work queues while maintaining knowledge of hospital departments and payer processes
• Follow up with third-party payers to clarify payment issues and ensure timely processing of appeals
• Compose administrative, non-clinical appeals and manage submission of appeal letters through various channels

Required qualifications

• High School diploma or equivalent
• One year of training in medical billing, coding, insurance processing, or related experience
• Knowledge and experience with EPIC medical billing preferred
• Experience with Microsoft Excel and Word
• Experience with hospital billing preferred