AR Recovery/Healthcare Denials Specialist (On-site Plano, TX)
On-sitePlano, Texas, United States
Plano, Texas, United StatesOn-siteFull TimeBachelors DegreeLarge
Full TimeBachelors DegreeLarge
Job Summary
Healthcare Denials Specialist II on-site in Plano, TX, who analyzes and resolves payer denials and underpayments, calls healthcare insurance companies and providers to resolve issues, analyzes contracts, billing and collections for accurate reimbursement, identifies denial trends for process improvements, creates appeals and payer communications, maintains HIPAA compliance, and mentors junior representatives; role utilizes advanced ARO software to streamline medical claims and collections.
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
- This role requires on-site work at FinThrive's Plano, TX office
Desired Qualifications
- Medicaid, Medicare, and Commercial billing experience
- Associate or Bachelor’s degree
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