Denials Specialist

Job Summary

A company is looking for a Denials Specialist.

Key Responsibilities:

• Validating denial reasons and ensuring accurate coding in DCM
• Generating appeals for denied or underpaid claims based on dispute reasons
• Researching contract terms and compiling necessary documentation for appeals

Required Qualifications:

• High School Diploma or equivalent, some college coursework preferred
• 3-5 years experience in a hospital business environment performing billing and/or collections
• Intermediate understanding of Explanation of Benefits form (EOB) and Managed Care Contracts
• Intermediate knowledge of ICD-9, HCPCS/CPT coding, and medical terminology
• Intermediate Microsoft Office (Word, Excel) skills