Denials Specialist

A company is looking for a Denials Specialist. Key Responsibilities Validate denial reasons and ensure accurate coding in the DCM system Generate appeals based on dispute reasons and payer guidelines Research contract terms and compile documentation for appeals Required Qualifications High School Diploma or equivalent; some college coursework preferred 3 - 5 years of experience in a hospital business environment related to billing and/or collections Intermediate understanding of Explanation of Benefits (EOB) and Managed Care Contracts Intermediate knowledge of hospital billing form requirements (UB-04) Intermediate understanding of ICD-9, HCPCS/CPT coding, and medical terminology

Mar 4, 2025 - 22:37

A company is looking for a Denials Specialist. Key Responsibilities Validate denial reasons and ensure accurate coding in the DCM system Generate appeals based on dispute reasons and payer guidelines Research contract terms and compile documentation for appeals Required Qualifications High School Diploma or equivalent; some college coursework preferred 3 - 5 years of experience in a hospital business environment related to billing and/or collections Intermediate understanding of Explanation of Benefits (EOB) and Managed Care Contracts Intermediate knowledge of hospital billing form requirements (UB-04) Intermediate understanding of ICD-9, HCPCS/CPT coding, and medical terminology