Insurance Specialist - Denials Resolution

Job Summary

Focused on resolving insurance processing errors and denials, the full-time remote Insurance Specialist - Denials Resolution will analyze payer payments, interpret guidelines, and conduct detailed account analysis to ensure accurate and timely payments for hospital and physician billing challenges.

Key responsibilities:

• Analyze payer payments to identify underpayments and reimbursement discrepancies
• Conduct detailed account analysis to resolve complex denials and payment variances
• Submit timely, accurate appeals and process credit resolutions in alignment with payer guidelines

Required qualifications:

• High School Diploma/GED
• Minimum of 3 years of experience in denials and credit resolution
• 2+ years of medical billing and follow-up experience
• Strong analytical skills with the ability to interpret payer guidelines
• Proficiency with PC-based applications (Microsoft Outlook, Word, and Excel)