Denial Coordinator

Denial Coordinator

Insight Global is looking for a Denial Coordinator to support a large hospital system in the Maryland/DC area. This person will support the Denials Appeals and Performance team, a centralized hospital denial team serving 10 hospitals. This role is hospital-based and denial-type driven, with work assigned via CARC codes rather than by inpatient or outpatient setting. Denials primarily include no-authorization (technical) and medical necessity/level-of-care (clinical) denials. Denial Coordinators work closely with RN reviewers and fellow technical staff in a fast-paced, collaborative environment. This is a production-focused role, with an expected daily volume of approximately 40 appeals per day, varying in complexity.

Primary responsibilities include:

• Work hospital denial accounts routed through proprietary system based on denial reason
• Review denial letters to determine appeal feasibility and next steps
• Draft and submit clear, detailed appeal letters for: no-authorization denials (technical) medical necessity and level-of-care denials (in partnership with RNs)
• Collaborate daily with: RN reviewers other denial coordinators leadership and managed care partners as needed
• Maintain timely follow-up on appealed accounts to ensure resolution
• Identify denial trends and escalate issues appropriately
• Participate in: daily huddles case review meetings interdisciplinary denial discussions
• Support special projects related to denial trends, payer behavior, or backlog reduction
• Adapt to evolving workflows as the DAP team continues to build and scale

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.