Claims Specialist

Healthcare Claims Denial & AR Management Specialist Contract to Hire Onsite - Addison TX 75001 About the Company Our client is a healthcare revenue cycle and medical billing organization dedicated to helping healthcare providers maximize reimbursement accuracy and efficiency. They partner with practices and providers to manage the full claims lifecycle — from submission through resolution — while maintaining strict compliance with payer and regulatory standards. Job Description We're seeking a detail-oriented Healthcare Claims Denial Management Specialist to identify, analyze, and resolve denied or underpaid medical insurance claims. This role is critical to ensuring accurate and timely reimbursement, working cross-functionally with payers, internal billing teams, and healthcare providers to reduce denial rates and improve revenue cycle performance. What You'll Be Responsible For Reviewing and analyzing denied, underpaid, and rejected medical claims to determine root causes Correcting claim errors, updating coding or documentation as needed, and resubmitting claims to payers within required timeframes Following up with insurance companies to resolve outstanding denials and secure payment Communicating directly with insurance representatives to verify claim status and resolve discrepancies Maintaining detailed documentation of actions, correspondence, and outcomes in billing/practice management systems Identifying denial patterns and trends across payers, coding categories, or service lines Collaborating with coding, billing, and clinical teams to prevent future denials through process improvements and training Preparing and submitting formal appeals with supporting medical records, coding references, and payer policy documentation Tracking appeal outcomes and ensuring compliance with appeal deadlines and payer regulations Ensuring claim corrections and submissions comply with federal, state, and payer-specific regulations Generating denial reports, analyzing metrics, and providing insights to leadership Monitoring KPIs such as denial rate, appeal success rate, and days in accounts receivable (A/R) Required Experience/Skills 2–4 years of experience in medical billing, claims processing, or denial management within a healthcare or payer environment Strong knowledge of revenue cycle processes Proficiency with CPT/HCPCS and ICD-10 coding Familiarity with insurance payer rules (commercial, Medicare, Medicaid) Solid understanding of medical terminology Proficiency with EMR/EHR systems, clearinghouses, and billing software Strong analytical skills with attention to detail and the ability to identify trends and interpret payer policies Excellent verbal and written communication skills Strong organizational skills with the ability to manage multiple priorities and deadlines Nice-to-Haves CPC, CPB, or other AAPC/AHIMA certification Experience in high-volume claims environments Familiarity with appeals and audit processes Education High school diploma or equivalent required; Associate's or Bachelor's degree in healthcare administration, business, or related field preferred Pay Summary $27/hr. W2 Apply Now! Denial Management Specialist, Medical Billing, Claims Processing, Revenue Cycle Management, CPT, HCPCS, ICD-10, Medical Coding, Insurance Appeals, EMR, EHR, Accounts Receivable, Healthcare Billing, Payer Relations, Medicare, Medicaid, AAPC, AHIMA, CPC, CPB #J-18808-Ljbffr