Denials Specialist

Denials Specialist OptySuite - 1.0 Farmington, MI Job Details Full-time 2 hours ago Benefits Health insurance Dental insurance Employee assistance program Vision insurance 401(k) matching Flexible schedule Life insurance Qualifications Record keeping Medical office experience Data management Electronic health record (EHR) management for billing and coding Attention to detail Medical billing and coding communication with insurance companies Medical denial root cause analysis (RCA) Medical claims submission Insurance provider collaboration Health information management Managing patient records Medical terminology Documentation review DRG Full Job Description Job Overview We are seeking a detail-oriented and proactive Denials Specialist to join our dynamic healthcare team. In this vital role, you will be responsible for reviewing, analyzing, and resolving insurance claim denials to ensure maximum reimbursement for medical services provided. Your expertise in medical coding, billing, and insurance processes will help streamline revenue cycle management and improve overall financial performance. If you thrive in a fast-paced environment and are passionate about accuracy and problem-solving, this is the perfect opportunity to make a meaningful impact in healthcare administration. Duties Review and analyze denied insurance claims to identify reasons for denial and determine appropriate resolution strategies Utilize knowledge of DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology) coding, ICD-9, and ICD-10 codes to accurately reprocess claims Communicate with insurance companies to appeal denied claims and follow up on outstanding issues Collaborate with medical billing teams to correct errors related to medical records, coding inaccuracies, or documentation gaps Maintain detailed records of denial reasons, actions taken, and outcomes within electronic health record (EHR) or electronic medical record (EMR) systems Stay updated on changes in insurance policies, coding guidelines, and healthcare regulations affecting claim processing Assist in training new team members on denial management procedures and best practices Requirements Proven experience in medical coding, billing, or collections within a healthcare setting Strong understanding of DRG classifications, CPT coding, ICD-9/ICD-10 coding systems, and medical terminology Familiarity with medical records management and insurance claim submission processes Experience working with Athena and

EPIC EMR/EHR

systems. Excellent communication skills to liaise effectively with insurance providers and internal teams Ability to analyze complex claims data quickly and accurately to resolve denials efficiently Prior experience in a medical office environment or healthcare administration is highly preferred Join us as a Denials Specialist and be part of a dedicated team committed to optimizing revenue cycles while ensuring excellent patient care support. Your expertise will directly contribute to the financial health of our organization and help us deliver exceptional service every day.

Benefits:

401(k) matching Dental insurance Employee assistance program Flexible schedule Health insurance Life insurance Vision insurance

Work Location:

In person