Medical Denials Specialist

Our client is seeking a detail-oriented Medical Denials Specialist with strong experience in insurance collections to join their healthcare revenue cycle team. This role is responsible for researching, appealing, and resolving denied medical claims to ensure maximum reimbursement from insurance carriers. The ideal candidate will have a solid understanding of payer guidelines, claims follow-up, and the collections process within a medical billing environment.Key Responsibilities:Review and analyze denied, underpaid, and rejected insurance claimsInvestigate denial reasons and take appropriate corrective actionPrepare and submit claim appeals with supporting documentationPerform follow-up with commercial insurers, government payers, and other third-party payersWork insurance aging reports and prioritize outstanding accounts for collectionResolve claim edits, authorization issues, coding discrepancies, and eligibility problemsDocument all account activity accurately and thoroughly in the billing systemCollaborate with billing, coding, and provider office teams to identify denial trends and improve reimbursementMaintain knowledge of payer rules, reimbursement policies, and regulatory requirementsMeet productivity and collection goals while ensuring accuracy and compliance