Denials Management Specialist

The Denials Management Specialist is responsible for analyzing denied claims, preparing and submitting appeal letters, and working with insurance companies to resolve denied claims efficiently.
Key Responsibilities:
- Analyze denied claims to identify reasons for denial.
- Prepare and submit detailed appeal letters to insurance companies.
- Follow up with insurance companies to resolve denied claims.
- Collaborate with billing and coding teams to ensure accurate claim submissions.
- Maintain detailed records of denial reasons, appeals submitted, and outcomes.
- Identify trends in denials and provide feedback to prevent future occurrences.
- Communicate with patients and healthcare providers regarding the status of denied claims.
- Stay updated on changes in insurance policies and guidelines.
Qualifications:
- Bachelors degree in Healthcare Administration, Business, or a related field.
- 3+ years of experience in medical billing, coding, or denials management.
- Strong understanding of insurance policies, guidelines, and regulations.
- Excellent analytical and problem-solving skills.
- Proficiency in medical billing software and Microsoft Office Suite.
- Strong communication and negotiation skills.
- Attention to detail and the ability to work independently.