Denials Specialist

About the Role

This position ensures that insurance and other 3rd party claims are submitted and/or paid in a timely manner and are compliant with applicable regulations and payer requirements. Specific assignments may include pre-adjudication and/or follow-up, facility and/or professional claims, commercial and/or government payers. Effective performance of these functions helps the organization achieve strong cash flow and maximize patient satisfaction.

Responsibilities

• Submit and follow up on insurance and third-party claims to ensure timely payment.
• Ensure compliance with applicable regulations and payer requirements.
• Handle pre-adjudication and follow-up for facility and professional claims.
• Work with commercial and government payers.

Requirements

• Strong attention to detail and demonstrated problem resolution skills.
• Effective verbal and written communication skills.
• Moderate proficiency with personal computers, including word processing, spreadsheets, and email (preference for Microsoft Suite).
• Working knowledge of typical office equipment.

Preferred Qualifications

• Experience in a health care revenue cycle environment.
• Knowledge of department/company processes, government policy/regulation, and payer requirements.
• Prior medical terminology and procedural/diagnostic coding (CPT, ICD) knowledge.
• Proficiency with Health Information Systems (e.g., Epic).

Benefits

• Medical insurance
• Dental insurance
• Retirement program
• Paid time off
• Insurance options
• Tuition reimbursement
• Employee assistance program
• Onsite clinic

About Us

At HealthPartners, we believe in the power of good – good deeds and good people working together. As part of our team, you’ll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work. We’re a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improves lives around the world.

At HealthPartners, everyone is welcome, included, and valued. We’re working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.