Senior Denials and Appeals Specialist

Job Summary

Managing complex insurance denials, the full-time Senior Denials and Appeals Specialist will oversee the appeals process, analyze denied claims, and collaborate with various departments to optimize the revenue cycle while working remotely.

Key Responsibilities

• Oversee and manage the appeals process for denied claims, ensuring timely and accurate submission of appeal documentation
• Analyze denied claims to identify root causes and collaborate with departments to implement corrective actions
• Work closely with billing, coding, and clinical teams to address denial issues and provide guidance on proper practices

Required Qualifications

• College degree preferred or equivalent experience of 5+ years in medical billing, with a strong preference for molecular laboratory billing experience
• Understanding of patient protections under HIPAA and handling of protected health information (PHI)
• Working knowledge of health insurance terminology and guidelines
• Strong analytical abilities and attention to detail
• Proficiency in Microsoft Office Suite and healthcare software tools