Denials Specialist

Denials Specialist Medical Billing

SynergenX | Low T Center | HerKare are leading providers of hormone replacement therapy and targeted wellness services. We're looking for a detail-oriented and dependable Denials Specialist to join our Billing Department in Houston, Texas!

In this role, you'll play an important part in keeping our billing operations running smoothly by researching denied claims, preparing appeals, correcting billing issues, and helping ensure timely reimbursement from insurance carriers. The ideal candidate is organized, communicates effectively, and enjoys problem-solving in a fast-paced, team-oriented environment.

This is a great opportunity for someone looking to grow their experience in medical billing and contribute to a supportive team!

Responsibilities

• Review and work aged accounts for assigned payers, prioritizing claims approaching timely filing deadlines.
• Research and correct current claim rejections (1120 days old) and rebill claims as needed.
• Prepare and submit appeals to insurance carriers according to payer guidelines.
• Document all account activity, maintain accurate notes, and track appeal outcomes.
• Verify and maintain documentation of insurance eligibility.
• Provide status updates and reports to the Billing Supervisor and management as requested.
• Meet or exceed established deadlines, productivity standards, and departmental goals.
• Communicate promptly with management regarding system issues, payer concerns, or billing discrepancies.
• Stay up to date on payer requirements, billing procedures, and applicable coding guidelines.
• Collaborate with team members, share knowledge, and participate in cross-training and professional development.
• Follow company policies and confidentiality standards at all times.
• Assist with special projects and provide administrative or clerical support to clinic staff as needed.

Core Competencies

• Adaptability: Effectively manages competing priorities and adjusts to changing needs.
• Integrity & Ethics: Demonstrates honesty, accountability, and respect.
• Communication: Communicates clearly and professionally, both verbally and in writing.
• Customer Service: Responds to questions and concerns with professionalism and courtesy.
• Dependability: Demonstrates reliability, punctuality, and a commitment to quality work.
• Teamwork: Works collaboratively and contributes to a positive team environment.

Requirements

• High school diploma or GED required.
• Strong attention to detail and commitment to accuracy.
• Excellent written and verbal communication skills.
• Ability to multitask, prioritize responsibilities, and meet deadlines.
• Team-oriented mindset with a strong customer service focus.
• Proficiency in Microsoft Office, including Word, Excel, and Outlook.
• Previous medical billing or medical office experience preferred, but not required.

Compensation

$18 per hour

Benefits

• Health, dental, and vision insurance
• Disability insurance
• 401(k) with 5% company match
• Paid time off (PTO)
• Tuition reimbursement
• Employee discount for you and one additional person

AI Note-Taking Disclosure

As part of our interview process, we may use an AI-assisted tool for note-taking and documentation. AI does not make hiring decisions or independently evaluate or select candidates. All employment decisions are made by our hiring team based on the candidate's qualifications, experience, and overall fit for the position.

Application Questions

Please submit all application-related questions and inquiries through the application platform.