AR Recovery/Healthcare Denials Specialist (On-site Plano, TX)
On-sitePlano, Texas, United States
Job Summary
Healthcare Denials Specialist II at FinThrive, on-site in Plano, TX, analyzes and resolves payer denials and underpayments. You will call healthcare insurers, affiliates, and providers to resolve issues, analyze contracts and billing to ensure accurate reimbursement, identify denial trends for process improvements, create appeals and payer communications to support resolutions, and maintain HIPAA-compliant documentation. The role requires 3+ years in healthcare insurance billing/follow-up, deep payer-rule knowledge, experience with EHR systems (EPIC, Paragon, Zirmed or similar), familiarity with UB-04/CPT/ICD/DRG codes, strong communication and analytical skills, and proficiency in Excel/Word. Mentoring junior representatives and using advanced ARO software to streamline medical claims and collections are also included, with on-site work at FinThrive's Plano, TX office.
Required Qualifications
- 3+ years of proven success with healthcare insurance billing, follow-up, reimbursement and collections in a hospital or BPO vendor environment
- Deep knowledge of payer rules, including how to interpret denial reasons and submit appeals
- Experience with healthcare billing/EHR systems (EPIC, Paragon, Zirmed, or similar)
- Strong understanding of medical terminology including claim types (UB-04), CPT, ICD, DRG codes, and EOB/RA
- Ability to identify and resolve complex denials and underpayment issues
- Excellent communication skills both written and verbal
- Strong problem-solving and analytical skills to assess insurance payment discrepancies
- Proficiency in Microsoft Excel and Word
Desired Qualifications
- Medicaid, Medicare, and Commercial billing experience
- Associate or Bachelor’s degree
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