Billing Denial Management Specialist; 10.28.26

Canyonlands Healthcare; Phoenix (AZ); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Vacation Time

Paid Leave

Medical, Dental, Vision, Life

Short-Term & Long-Term Disability

Accident & Critical Insurance

Retirement plan offered

Job summary

Canyonlands Healthcare in Phoenix is seeking a Billing Denial Management Specialist to join our billing team. The role focuses on managing denied, rejected, and underpaid medical and behavioral health claims to ensure timely reimbursement and accurate financial records.

You will review payer responses, investigate root causes of denials, prepare appeals, and collaborate across departments to streamline workflows.

Qualifications

• Requires high school diploma; healthcare billing or coding cert preferred.
• Experience with medical billing, claims management, or denial resolution.
• Strong understanding of payer requirements and billing regulations.
• Excellent analytical and problem-solving skills with attention to detail.
• Proficiency in billing software, EHR, and MS Office.

Responsibilities

• Identify, investigate, and resolve denied, rejected, and underpaid claims for medical and behavioral health services.
• Review payer responses and root causes of denials.
• Correct claim issues and prepare appeals to facilitate reimbursement.
• Perform insurance follow-up to ensure timely processing.
• Document account activity and maintain accurate records.
• Analyze denial trends to improve processes and reduce denials.
• Collaborate with team to streamline billing workflows and efficiency.
• Support accounts receivable by keeping receivables within limits.

Skills

Analytical thinking

Attention to detail

Communication skills

Teamwork

Independent worker

Insurance knowledge

Education

High school diploma

Healthcare billing/coding certification (preferred)

Tools

Billing software

EHR (Electronic Health Records)

Microsoft Office

Job description

Description

Billing Denial Management Specialist

Canyonlands Healthcare, a dedicated Federally Qualified Health Center (FQHC), is seeking a detail-oriented and proactive Billing Denial Management Specialist to join our billing team. This role is vital in ensuring accurate and timely reimbursement by effectively managing and resolving denied, rejected, and underpaid medical and behavioral health claims. If you are committed to improving healthcare financial processes and supporting our mission to provide quality care, we invite you to apply.

Key Responsibilities:

• Identify, investigate, and resolve denied, rejected, and underpaid claims for medical and behavioral health services.
• Review payer responses and documentation to determine the root causes of claim denials.
• Correct claim issues and prepare appeals and reconsiderations to facilitate claim reimbursement.
• Perform insurance follow-up activities to ensure claims are processed accurately and promptly.
• Document account activity thoroughly and maintain accurate records of all interactions and resolutions.
• Analyze denial trends to identify opportunities for process improvements and reduce future claim denials.
• Collaborate with team members and other departments to streamline billing workflows and enhance overall efficiency.
• Support accounts receivable management by ensuring that receivables are kept within acceptable limits and do not grow unnecessarily.

Skills and Qualifications:

• High school diploma or equivalent; additional education or certification in healthcare billing or coding preferred.
• Proven experience in medical billing, claims management, or denial resolution, preferably within a healthcare setting.
• Strong understanding of insurance policies, payer requirements, and billing regulations.
• Excellent analytical and problem-solving skills with attention to detail.
• Proficiency in billing software, electronic health records (EHR), and Microsoft Office Suite.
• Effective communication skills, both written and verbal, to interact with payers, providers, and team members.
• Ability to work independently and as part of a team in a fast-paced environment.
• Knowledge of federal and state healthcare regulations and compliance standards.

Employee Benefits:

• Vacation Time
• Paid Leave
• Medical, Dental, Vision, Life
• Short-Term & Long-Term Disability
• Accident & Critical Insurance
• Retirement plan offered

Join our team and be part of a supportive, growth-oriented organization committed to delivering exceptional healthcare services. We offer a collaborative work environment, opportunities for professional development, and a chance to make a meaningful impact in our community.