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Medical Denials Specialist

Job

Robert Half

Carmel-by-the-Sea, CA (In Person)

Full-Time

Posted 4 weeks ago (Updated 6 days ago) • Actively hiring

Expires 7/1/2026

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Job Description

We are seeking a detail-oriented Medical Denials Specialist to join our healthcare revenue cycle team. In this role, you will be responsible for reviewing, analyzing and resolving denied medical claims to support timely reimbursement and reduce revenue loss. The ideal candidate will have experience working with insurance carriers, payer guidelines, appeals processes and healthcare billing systems.
Hours:
Monday - Friday 8am -5pmKey ResponsibilitiesReview and investigate denied or underpaid medical claimsIdentify denial trends and root causes to support process improvementPrepare and submit claim corrections, reconsiderations and appealsFollow up with insurance companies regarding claim status and payment resolutionVerify coding, billing and documentation accuracy to ensure compliance with payer requirementsCollaborate with billing, coding, collections and clinical teams to resolve claim issuesMaintain accurate records of denial activity, appeal outcomes and account updatesMonitor payer policy changes and reimbursement guidelinesMeet productivity and quality goals related to denial resolution and accounts receivable follow-up