Denials Management Specialist

Job Summary

Managing denial and accounts receivable (AR) processes, the full-time Denials Management Specialist will resolve claim edits, research outstanding denials, and manage insurance appeals in a remote setting.

Key responsibilities

• Review and resolve daily claim scrubber edits based on coding and billing guidelines
• Research and address outstanding denials while completing necessary follow-up in a timely manner
• Identify denial trends and educate staff on prevention strategies to reduce future denials

Required qualifications

• High School Graduate with some college education
• 5+ years of experience in medical billing/collections, specifically with denials and appeals
• Extensive knowledge of ICD9 and CPT-4 coding, as well as insurance explanation of benefits (EOB)
• Proficiency in Microsoft Office, particularly Excel and Word
• Familiarity with multiple payer requirements for claims processing