Location:

Buford, GA Schedule:

Monday - Friday, 9:00 AM - 5:30

PM Job Type:

Full-Time, Onsite Pay:

$18.00 - $19.50 per hour About the Position We are seeking an experienced Denial Management Specialist with a strong background in laboratory and medical billing to join our growing team in Buford, GA. The ideal candidate will be responsible for identifying, analyzing, appealing, and resolving denied insurance claims while driving process improvements that reduce denials and maximize reimbursement. This role requires a proactive professional who can recognize denial patterns, identify root causes, and collaborate with leadership to develop strategies that improve revenue cycle performance and payer outcomes. Key Responsibilities Review and analyze denied, rejected, and underpaid claims for laboratory and medical services. Investigate denial trends and identify root causes impacting reimbursement. Prepare and submit appeals with supporting documentation to insurance carriers. Follow up with payers regarding claim status, appeal determinations, and payment resolutions. Monitor denial metrics and identify opportunities for process improvement. Analyze payer-specific denial trends and communicate findings to management. Collaborate closely with leadership, billing teams, coding staff, and revenue cycle personnel to implement corrective actions and reduce future denials. Provide recommendations based on denial data to improve claim submission accuracy and reimbursement outcomes. Ensure compliance with payer guidelines, billing regulations, and company policies. Maintain detailed documentation of claim activities, appeals, resolutions, and payer communications. Meet established productivity, quality, and recovery goals. Qualifications Minimum of 2 years of denial management experience in medical billing and/or laboratory billing. Strong knowledge of commercial insurance, Medicare, Medicaid, and managed care plans. Experience with claim appeals, accounts receivable follow-up, and reimbursement analysis. Ability to identify denial trends, root causes, and revenue cycle improvement opportunities. Understanding of CPT, ICD-10, and HCPCS coding principles. Proficiency with medical billing software and EMR/EHR systems. Strong analytical, problem-solving, and critical-thinking skills. Excellent written and verbal communication skills. Ability to work independently while collaborating effectively with management and operational teams. Strong attention to detail and organizational skills. Preferred Qualifications Experience in laboratory revenue cycle management. Knowledge of payer-specific billing, reimbursement, and denial management guidelines. Experience creating denial trend reports and presenting findings to leadership. Certified Professional Biller (CPB), Certified Revenue Cycle Specialist (CRCS), or similar certification preferred. Benefits Monday-Friday schedule (No weekends) Professional and supportive work environment Opportunities for career growth and advancement Stable, full-time employment Apply Today! If you have experience resolving insurance denials, identifying payer trends, and partnering with leadership to improve revenue cycle performance, we encourage you to apply. Join our team and play a key role in maximizing reimbursement, reducing denials, and driving operational success.

Pay:

$18.00 - $19.50 per hour

Benefits:

Life insurance Paid time off Application Question(s): Attention to Detail Assessment Review the information below and identify as many errors or inconsistencies as possible.

Jennifer Smith Email:

jennifer.smith@email.con

Summary:

7 years of experiance in denials management and accurrate data entry. ABC Healthcare Solutions (March 2022-Present) Reduced denial rates by 15% during 2021. Worked with commerical payers. Utilized Microsoft Excell.

Skills:

Denials Managment Attention to

Detail Question:

List all errors you find.

Work Location:

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Denial Management Specialist Laboratory & Medical Billing (Onsite)