Denials Management Specialist

Job Summary

A company is looking for a Denials Specialist.

Key Responsibilities

• Analyze denied claims to identify reasons for denial and execute follow-up actions
• Communicate with payors to resolve account denials and ensure timely recovery of outstanding claims
• Maintain accurate records of claim activities and ensure compliance with regulations governing claims processing

Required Qualifications

• Minimum of 6 months experience in a hospital, payer, or relevant revenue cycle area
• Preferred experience in healthcare insurance billing, medical coding, and claim adjudication
• Experience with denials management and writing appeal letters
• Expertise in medical terminology and coding (ICD, CPT, HCPCS)
• Experience with healthcare billing systems (EPIC or similar)