Denials and Appeals Specialist

Job Summary

Working remotely in a full-time capacity, the Denials and Appeals Specialist will process correspondence, manage follow-ups on denied claims, and ensure compliance with billing regulations while contributing to a cooperative team environment.

Key responsibilities:

• Perform diligent follow-up and appeals processes to secure payment on outstanding claims
• Research and address denials with maximum collection efforts to minimize write-offs
• Maintain compliance with state and federal regulations while meeting productivity and quality standards

Required qualifications:

• Approximately two years of experience with insurance denial and correspondence processes
• High school diploma or equivalent; some college coursework preferred
• Knowledge of health insurance denial processing and coordination of benefits
• Understanding of physician billing guidelines for commercial and government payers
• Proficiency in Microsoft Excel, Outlook, and Word, with experience in billing systems preferred