Denials Resolution Specialist

Job Summary

A company is looking for a Denials Resolution Specialist II.

Key Responsibilities

• Review, analyze, and resolve complex denial issues by communicating with payers and hospital departments
• Identify trends in denials and participate in strategies to reduce future occurrences
• Train staff on payer websites and provide guidance on navigation for denial resolution

Required Qualifications

• High School diploma or equivalent
• Four or more years of experience in health care billing functions
• Previous experience in denial resolution processes
• Advanced knowledge of claim form content and submission requirements
• Ability to navigate MassHealth and Medicare claims processing applications