Denial Management Specialist

Job Summary

A company is looking for a Denial Management Specialist responsible for investigating and resolving complex third-party insurance denials and outstanding claims.

Key Responsibilities

• Conduct comprehensive research to resolve payer claim denials
• Write and submit detailed appeals based on clinical documentation and payer guidelines
• Track and trend recovery efforts while ensuring compliance with productivity standards

Required Qualifications

• Bachelor's degree or equivalent work experience
• 3+ years of experience in medical collections, specifically in denials and appeals
• Strong knowledge of healthcare terminology and CPT-ICD10 codes
• Complete understanding of insurance plans and coverage guidelines
• Basic computer proficiency, especially in Microsoft Suite applications