Denials Specialist

Job Summary

To maximize reimbursement from contracted payers, the full-time Denials Specialist will analyze, track, and trend denials while executing the appeal process and collaborating with various departments remotely.

Key responsibilities

• Evaluate denied accounts and assign them for resolution while identifying repetitive issues for preventative solutions
• Develop and maintain strong working relationships with hospital departments and payers to facilitate successful appeals and resolve denials
• Track the status of appeals and maintain organized records to ensure compliance with established timelines

Required qualifications

• Associate's degree in accounting, business office practices, computer science, or a related field, or equivalent experience
• Three to five years of experience in hospital patient accounting with knowledge of claims administration
• Familiarity with ICD-9/10, CPT-4 coding, UB04, and HCFA 1500 claims administration
• Ability to perform financial analysis and comprehensive knowledge of patient accounting activities in a complex healthcare environment
• Independently functions within the scope of department policies and practices