Denials Specialist

Denials Specialist

Onsite located in Houston Texas! SynergenX-Low T Center-HerKare, are leading providers of hormone replacement and targeted wellness services, seeking a Denials Specialist team member to join our Billing Department. This role is responsible for collecting and reviewing denial information, preparing appeals, and submitting necessary correspondence and documentation to carriers. The Denials Specialist will also research patient accounts to prevent billing rejections, track appeal outcomes, and provide regular reports to the Billing Supervisor. This position requires excellent attention to detail, strong communication skills, and the ability to manage multiple priorities in a fast-paced environment.

Responsibilities

• Review and work aged accounts on assigned payers, prioritizing those approaching timely filing deadlines.
• Research and correct current rejections (1120 days old) and re-bill claims as needed.
• Prepare and submit appeals to payers per guidelines; document all actions and track outcomes.
• Maintain clear notes on accounts, including proof of insurance eligibility.
• Provide status updates and reports to management as requested.
• Meet or exceed deadlines and department goals.
• Communicate promptly with management regarding system or payer issues.
• Support team members through knowledge sharing and collaboration.
• Participate in cross-training and personal development opportunities.
• Ensure accuracy by understanding payer rules, billing rules, and coding guidelines.
• Adhere to company policies and confidentiality standards at all times.
• Assist with special projects as assigned.
• Support clinic staff with administrative and clerical tasks as needed

Core Competencies

• Adaptability: Able to manage competing demands and adjust to changes.
• Integrity & Ethics: Works with honesty, accountability, and respect.
• Communication: Listens effectively and communicates clearly, both verbally and in writing.
• Customer Service: Professional, courteous, and responsive in handling customer needs.
• Dependability: Reliable, punctual, and committed to quality work.
• Teamwork: Collaborates effectively and contributes to a positive team environment.

Requirements

• High School Diploma or GED required.
• Excellent attention to detail and accuracy.
• Strong written and verbal communication skills.
• Ability to multitask and meet deadlines.
• Team-oriented with a strong customer service focus.
• Proficiency with Microsoft Office (Word, Excel, Outlook).
• Previous billing or medical office experience preferred, but not required.

Benefits

• Health, dental and vision insurance
• Disability insurance
• 401k with 5% matching
• PTO
• Tuition reimbursement
• Employee discount with a plus 1

Compensation: $18 hourly