Billing Denial Management Specialist; 10.28.26

Job Description

Job Description

Billing Denial Management Specialist

Canyonlands Healthcare, a dedicated Federally Qualified Health Center (FQHC), is seeking a detail-oriented and proactive Billing Denial Management Specialist to join our billing team. This role is vital in ensuring accurate and timely reimbursement by effectively managing and resolving denied, rejected, and underpaid medical and behavioral health claims. If you are committed to improving healthcare financial processes and supporting our mission to provide quality care, we invite you to apply.

Key Responsibilities:

- Identify, investigate, and resolve denied, rejected, and underpaid claims for medical and behavioral health services.

- Review payer responses and documentation to determine the root causes of claim denials.

- Correct claim issues and prepare appeals and reconsiderations to facilitate claim reimbursement.

- Perform insurance follow-up activities to ensure claims are processed accurately and promptly.

- Document account activity thoroughly and maintain accurate records of all interactions and resolutions.

- Analyze denial trends to identify opportunities for process improvements and reduce future claim denials.

- Collaborate with team members and other departments to streamline billing workflows and enhance overall efficiency.

- Support accounts receivable management by ensuring that receivables are kept within acceptable limits and do not grow unnecessarily.

Skills and Qualifications:

- High school diploma or equivalent; additional education or certification in healthcare billing or coding preferred.

- Proven experience in medical billing, claims management, or denial resolution, preferably within a healthcare setting.

- Strong understanding of insurance policies, payer requirements, and billing regulations.

- Excellent analytical and problem-solving skills with attention to detail.

- Proficiency in billing software, electronic health records (EHR), and Microsoft Office Suite.

- Effective communication skills, both written and verbal, to interact with payers, providers, and team members.

- Ability to work independently and as part of a team in a fast-paced environment.

- Knowledge of federal and state healthcare regulations and compliance standards.

Employee Benefits:

- Vacation Time

- Paid Leave

- Medical, Dental, Vision, Life

- Short-Term & Long-Term Disability

- Accident & Critical Insurance

- Retirement plan offered

Join our team and be part of a supportive, growth-oriented organization committed to delivering exceptional healthcare services. We offer a collaborative work environment, opportunities for professional development, and a chance to make a meaningful impact in our community.