Denials Management Medical Specialist

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.
• 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

• 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.