Denials Management Specialist

Denials Management Specialist is responsible for identifying, investigating, appealing, and resolving denied or underpaid insurance claims to maximize reimbursement and minimize revenue loss. This role collaborates with billing, coding, patient financial services, and clinical departments to ensure timely resolution of claim denials, identify root causes, and support process improvements that enhance revenue cycle performance. Responsibilities include reviewing and investigating denied, rejected, and underpaid claims from government and commercial payers to determine resolution strategies, preparing and monitoring appeals, following payer guidelines and organizational policies, communicating with carriers about claim status and discrepancies, analyzing denial trends, generating reports, and recommending process improvements to improve clean claim rates. Qualifications include a high school diploma or equivalent with two years of experience in healthcare revenue cycle operations preferred, knowledge of CPT/ICD-10-CM/HCPCS, experience with EHRs and revenue cycle systems, and strong analytical and communication skills. The role offers a pay range of $29.42-$42.02/hour with comprehensive benefits. Open until filled.