Healthcare Claims Denial/AR Management Specialist

Contract to Hire – Onsite in Addison, TX (75001)

About The Company

Our client is a healthcare revenue cycle and medical billing organization dedicated to helping healthcare providers maximize reimbursement accuracy and efficiency. They partner with practices and providers to manage the full claims lifecycle — from submission through resolution — while maintaining strict compliance with payer and regulatory standards.

Responsibilities

• Reviewing and analyzing denied, underpaid, and rejected medical claims to determine root causes
• Correcting claim errors, updating coding or documentation as needed, and resubmitting claims to payers within required timeframes
• Following up with insurance companies to resolve outstanding denials and secure payment
• Communicating directly with insurance representatives to verify claim status and resolve discrepancies
• Maintaining detailed documentation of actions, correspondence, and outcomes in billing/practice management systems
• Identifying denial patterns and trends across payers, coding categories, or service lines
• Collaborating with coding, billing, and clinical teams to prevent future denials through process improvements and training
• Preparing and submitting formal appeals with supporting medical records, coding references, and payer policy documentation
• Tracking appeal outcomes and ensuring compliance with appeal deadlines and payer regulations
• Ensuring claim corrections and submissions comply with federal, state, and payer-specific regulations
• Generating denial reports, analyzing metrics, and providing insights to leadership
• Monitoring KPIs such as denial rate, appeal success rate, and days in accounts receivable (A/R)

Requirements

• 2–4 years of experience in medical billing, claims processing, or denial management within a healthcare or payer environment
• Strong knowledge of revenue cycle processes
• Proficiency with CPT/HCPCS and ICD-10 coding
• Familiarity with insurance payer rules (commercial, Medicare, Medicaid)
• Solid understanding of medical terminology
• Proficiency with EMR/EHR systems, clearinghouses, and billing software
• Strong analytical skills with attention to detail and the ability to identify trends and interpret payer policies
• Excellent verbal and written communication skills
• Strong organizational skills with the ability to manage multiple priorities and deadlines

Qualifications

• High school diploma or equivalent required; Associate's or Bachelor's degree in healthcare administration, business, or related field preferred
• CPC, CPB, or other AAPC/AHIMA certification (nice-to-have)
• Experience in high-volume claims environments (nice-to-have)
• Familiarity with appeals and audit processes (nice-to-have)

Pay

$27/hr. W2