Denials Management Specialist

Compensation Hourly Pay Range: $22.14 - $33.21 (depending on experience and expertise) Position Highlights Position: Denial Management Specialist Location: Warrenville, IL Availability: Full Time Hours: Monday – Friday, 8:00a.m. – 4:30p.m. Overview Reviews claim denials related to medical necessity, pre‑certification, authorization, and level‑of‑care requirements. Requires interaction with physician practices, providers, and payers. Responsibilities Review and resolve denied patient insurance claims. Work closely with internal departments to determine accurate denial reasons and appeal processes. Contact insurance companies or patients to gather necessary information for appeals. Submit appeals to payers, including resubmission of corrected claims, medical records, and appeal letters. Recommend process improvements to supervisors to reduce future denials. Use software tools to identify denial trends and payer issues. Share findings with stakeholders. Follow up on pending claim denials after the appeal has been processed by the insurance company. Collaborate in data collection and send monthly “Managed Care Denial Report” to leadership and related departments (e.g., Physician Coding Manager, Physician Billing Manager, Director, VP of EEH Physician Practices, VP of EEH Revenue Cycle). Maintain positive working relationships internally and externally. Qualifications Education: High School diploma or equivalent required. Experience: 2 years in patient billing or 2 years managed care experience. Skills: Extensive computer knowledge, familiarity with standard billing guidelines, CPT/ICD‑9 coding, and usual & customary (U&C) schedules. Benefits Annual Incentive Plan (eligible positions). Premium pay for shift, on‑call, holiday, etc. (eligible positions). Incentive pay for select positions. Opportunity for annual increases based on performance. Career pathways for professional growth. Medical, dental, vision, and pet coverage. Tuition reimbursement. Free parking. Wellness program. Savings plan. Health savings account options. Retirement plans with company match. Paid time off and holiday pay. Equal Opportunity Employer Race/Color/Sex/Sexual Orientation/Gender Identity/Religion/National Origin/Disability/Veterans, VEVRRA, Federal Contractor. #J-18808-Ljbffr