Medical Denials Specialist
We are seeking a detail-oriented Medical Denials Specialist to join our healthcare revenue cycle team. This role is responsible for reviewing, researching, and resolving denied or underpaid medical claims to support timely reimbursement and reduce revenue loss. The ideal candidate has strong knowledge of payer guidelines, appeals processes, and healthcare billing workflows.
Hours: Monday - Friday 8am -5pm
Key Responsibilities:
- Review denied, rejected, or underpaid insurance claims and identify root causes
- Investigate payer denials related to coding, authorizations, eligibility, timely filing, medical necessity, and billing errors
- Prepare and submit appeals with appropriate supporting documentation
- Communicate with insurance carriers, patients, providers, and internal departments to resolve claim issues
- Monitor and track denial trends and escalate recurring issues for process improvement
- Maintain accurate and detailed account documentation in billing and practice management systems
- Follow up on outstanding appeals and denied claims to ensure timely resolution
- Partner with billing, coding, and patient access teams to reduce future denials
- Ensure compliance with payer requirements, HIPAA, and internal policies
Qualifications:
- High school diploma or equivalent required; associate or bachelor’s degree preferred
- 2+ years of experience in medical billing, claims follow-up, accounts receivable, or denial management preferred
- Working knowledge of ICD-10, CPT, HCPCS, EOBs, and payer reimbursement guidelines
- Familiarity with Medicare, Medicaid, and commercial insurance processes
- Strong analytical, organizational, and problem-solving skills
- Proficiency with electronic health records, billing software, and Microsoft Office
- Excellent written and verbal communication skills
Compensation
$18.00-$24.00 HourlyAbout Us
TalentMatch®
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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.
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