Hospital Denials Specialist

Job Summary

A company is looking for a Hospital Denials and Appeals Specialist-Remote.

Key Responsibilities

• Validate denial reasons and ensure accurate coding in DCM
• Generate appeals based on dispute reasons and payer contract terms
• 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 hospital billing forms (UB-04)
• Intermediate knowledge of ICD-9, HCPCS/CPT coding, and medical terminology
• Intermediate skills in Microsoft Office (Word, Excel)