Education –High school diploma/GED required. Associate’s degree preferred.
Experience – Five (5) years Revenue Cycle/Billing Office experience and Medicare billing required.
Licenses & Certification –
Knowledge & Skills –
The Denials Specialist is responsible for reviewing, analyzing, and resolving denied medical claims to ensure proper reimbursement for healthcare services. The Denials Specialist ensures timely and accurate resubmission or appeal of denied claims to optimize reimbursement and minimize revenue loss. This position works closely with payers, billing staff, and clinical teams to identify root causes of denials and implement solutions to prevent future occurrences. This position is in office/person (not remote).
Work is performed in a business office environment. Occasional overtime and travel may be required.
Required sitting and standing associated with a normal office environment. Manual dexterity is needed for using a calculator and computer keyboard. This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, skills and working conditions may change as needs evolve.
Satisfactory job performance will be determined by successful execution of the following:
Research denial reasons and take appropriate actions, including correcting claim errors, submitting appeals, or resubmitting claims.
Research denial reasons and take appropriate actions, including correcting claim errors, submitting appeals, or resubmitting claims.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.
