Denials Follow Up Specialist

Job Summary

Working remotely in a full-time capacity, the Denials Follow Up Specialist will manage the resolution of clinical and technical denials by reviewing documentation, negotiating with payers, and appealing denials using various methods.

Key responsibilities

• Differentiates between clinical and technical denials through EOBs, denial letters, and data mining
• Contacts payers to negotiate resolutions on technical denials and manages the appeals process
• Evaluates appeal outcomes and logs recovered funds, supporting decisions or initiating further appeals as necessary

Required qualifications

• Four-year degree preferred or equivalent experience in hospital-related billing/follow-up
• Knowledge of or experience with managed care contracts
• Experience in customer support or client issue resolution management
• Strong analytical skills and ability to multi-task
• Proficiency with MS Office