Revenue Specialist, Denials

Job Summary

A company is looking for a Revenue Specialist, Denials to manage the denials appeal process and resolve outstanding claims.

Key Responsibilities

• Review and evaluate denied claims using proprietary software and payment documentation to determine correct reimbursement
• Research and acquire necessary medical records and submit them with claims to ensure prompt reimbursement
• Conduct timely follow-up with payers to confirm receipt of claims and facilitate reimbursement

Requirements and Qualifications

• High School Diploma or GED required; Associates or Bachelor's Degree preferred
• 5+ years of experience in healthcare billing or collections
• 1+ years of client-facing/customer service experience
• Intermediate understanding of insurance payer/provider claims processing and medical terminology
• Strong computer proficiency, including MS Office applications