Billing Denials Specialist

About the Role

A Billing Denials Specialist at CRMC manages and appeals insurance claim denials to ensure accuracy and optimize reimbursement. You will resolve credit discrepancies in patient accounts, support audit processes, and interact with the Denials Committee and Business Office staff through monthly and quarterly presentations. Leadership duties include training new staff and overseeing their daily tasks to ensure compliance and efficiency. Flexibility in scheduling, including potential rotating shifts, is required.

About the Business Office Department

The Business Office team at CRMC is dedicated to maintaining financial integrity while prioritizing patient care. Our collaborative environment values flexibility, problem-solving, and clear communication. We handle claims processing, reimbursements, revenue cycle analysis, and staff training with a focus on fairness, accuracy, and efficiency. Though many team members didn’t initially pursue healthcare finance, we find purpose in supporting patients through the financial aspects of their healthcare journey.

Responsibilities

• Manage and appeal insurance claim denials to optimize reimbursement.
• Identify and resolve credit discrepancies in patient accounts.
• Support audit processes and ensure compliance.
• Present updates and educational content to the Denials Committee and Business Office staff.
• Train and oversee newer staff to ensure efficiency and adherence to standards.
• Adapt to changing departmental needs, including potential rotating shifts.

Ideal Candidate

• Analytical problem solver.
• Independent worker with strong communication skills.
• Adaptable to change and capable of leadership.
• Detail-oriented with a focus on accuracy.

Requirements

• Successful completion of data entry, general clerical, ten-key, and denials specialist standards administered by CRMC Human Resources.
• Associate’s degree in healthcare or business administration and/or related coursework or three (3) years of comparable experience in a related healthcare field.

Benefits

• Medical, dental, and vision insurance.
• Health savings accounts (HSA).
• Life insurance.
• Employer contributions to a 401(k) retirement plan.
• Paid time off (PTO).
• 401(k) and 457(b) retirement plans.
• Educational assistance and reimbursement.
• Employee assistance program (EAP).
• Work-life balance support.
• Gym membership and other discounts.
• Employee recognition programs.

Pay is determined based on experience in this role. A full job description is available upon request or when an interview is scheduled.