Denials Specialist

Job Summary

A company is looking for a Denials Specialist-Remote.

Key Responsibilities

• Validate denial reasons and ensure accurate coding in the DCM system
• Generate appeals based on dispute reasons and follow payer guidelines for submission
• Research contract terms and compile documentation for appeals and corrective actions

Required Qualifications

• High School Diploma or equivalent; some college coursework preferred
• 3 - 5 years of experience in a hospital business environment, specifically in billing and/or collections
• Intermediate understanding of Explanation of Benefits (EOB), Managed Care Contracts, and hospital billing form requirements
• Intermediate knowledge of ICD-9, HCPCS/CPT coding, and medical terminology
• Intermediate skills in Microsoft Office (Word, Excel)