Medical Denials Specialist
robert halfCarmel (IN)
Medical Denials Specialist
Posted yesterday
robert halfCarmel (IN)
Medical Records SpecialistsPharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds
SENIORITY
Senior
About the role
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
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