Denials Management Medical Specialist

Company Summary

Our client is seeking a Denials Management Medical Specialist to join their Billing & Collections team. This is an excellent opportunity for an experienced medical billing professional who thrives in a fast-paced environment and enjoys resolving claim issues, managing denials, and ensuring timely reimbursement. The ideal candidate will be organized, detail-oriented, and possess a strong understanding of insurance billing and collections processes.

Responsibilities

• Follow up on denied and outstanding claims to ensure timely resolution and reimbursement.
• Research, review, and document claim denials and appeals.
• Submit electronic and paper claims as needed.
• Obtain supporting documentation required for claim processing and acceptance.
• Communicate effectively with insurance carriers, patients, and internal departments.
• Maintain accurate account notes regarding claim submissions, denials, appeals, and resolutions.
• Enter and update patient demographic and billing information in the billing system.
• Monitor claim status and take appropriate action to resolve outstanding balances.
• Adhere to company policies, procedures, and regulatory requirements.
• Perform additional duties as assigned.

Qualifications

• Must have Experience with Epic
• Recent experience in medical billing, collections, denial management, or revenue cycle operations.
• Strong knowledge of insurance claim processing and reimbursement methodologies.
• Familiarity with ICD-10 coding and HIPAA regulations.
• Proficiency with Microsoft Word, Excel, and Outlook.
• Excellent verbal and written communication skills.
• Strong attention to detail and organizational skills.
• High School Diploma or equivalent required.
• Coding background is a plus

Schedule

• Full-Time
• Hybrid work model
• Location: Farmington, CT
• Can start your day as early as 7:30 AM and finish as late as 6:00 PM (within a 40 hour window)

Pay Rate

$23 - $25.50 per hour (based on experience)

Benefits

• Hybrid Work Opportunity!
• PTO 13 Days on an accrual basis.
• Very nice office and kitchen space, recently moved to a new building.
• 401K 3% match.
• Full benefits.
• Excellent Workplace Environment.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, Los Angeles County Fair Chance Ordinance, and San Francisco Fair Chance Ordinance.