Denials & Appeals Specialist

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Denials & Appeals Specialist Full Time Dallas, TX, US 6 days ago Requisition ID: 1259 Salary Range: $55,000.00 To $65,000.00 Annually Location - Mesquite Join our team! Are you looking for an opportunity to serve a bigger purpose with a growing organization? Are you passionate and dedicated to making a positive impact? Then we have a spot waiting for you. We are seeking an engaging Denial and Appeal Specialist to join our growing team in Mesquite. As part of the HHM team, you would be responsible for reviewing, analyzing, and resolving denied healthcare claims by preparing and submitting appeals to insurance companies. This role ensures proper reimbursement by identifying root causes of denials and working closely with billing, coding, and clinical teams. Responsibilities Review and analyze denied insurance claims across all payer types (Medicaid, MCO’s, Medicare, Commercial etc.) Perform detailed denial analysis to determine root cause (coding, documentation, eligibility, authorization, billing errors, payer issues) Prepare and submit accurate and timely appeal requests with supporting documentation Own assigned denial inventory and ensure timely resolution Follow up with insurance companies on appeal status and resolution Collaborate with providers, coders, and billing teams to gather required information Track and document all appeals, outcomes, and correspondence Identify denial trends and recommend process improvements to reduce future denials Ensure compliance with payer policies, coding standards, and HIPAA regulations Develop workflows and improve denial management processes Qualifications To be a productive member of our team, you will have a pleasant and professional demeanor, be a self-starter, have the ability to work independently, strong communication skills and the ability to preserve confidentiality. You will also have the following: High school diploma or equivalent (Associate’s or bachelor’s preferred) 3-5 years of related experience, prior experience in a revenue cycle with a community-based setting with focus on denials and appeals Experience in medical billing, coding, or revenue cycle management along with experience with Medicaid, Medicare, and commercial payers CPC or CPB is a plus Knowledge of CPT, ICD-10, and HCPCS coding systems Familiarity with insurance payer policies and claims processes Experience with EMR/EHR and billing software Bilingual (English/Spanish) a plus Benefits Health Savings Account 403(b) retirement savings plan with dollar-for-dollar matching up to 3% and match 50% of the next 2% (contribute 5% to get 4% matched). 100% vested upon enrollment. Generous paid time off plan for full-time employees (includes Sick and Volunteer Days) Paid Holidays Accidental Death & Dismemberments (ADD) plan Short-term & Long-term Disability Employee Assistance Programs (EAP) HHM CARES Fund (employee emergency relief fund) Equal Opportunity Employer HHM Health is committed to providing equal employment opportunity to all individuals regardless of their race, color, religion, gender identity and expression, age, sexual orientation, national origin, disability, veteran status, marital status or any other characteristic protected by federal, state or local law. HHM Health hires and promotes based solely on the qualifications of the individual and the essential functions of the job being filled. Monday through Friday - 8 am to 5 pm (1 hr lunch) #J-18808-Ljbffr