Claims Denials & Appeals Analyst

Tenet Healthcare; Frisco, Northern (TX, KY); Hybrid; USD 25,000 - 39,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

401k with employer match

Paid time off

Job summary

Conifer Health, part of the Tenet family, seeks a disputes specialist to validate denial reasons, prepare appeals, and coordinate with payers to optimize reimbursement. You will work with the Clinical Resource Center for consultations and ensure accuracy in coding for EOB resolutions.

Typical duties include researching contracts, producing supporting documentation, and escalating trends to leadership. Hospital billing experience and strong MS Office skills are essential.

Qualifications

• High School Diploma or equivalent; some college coursework preferred.
• 3–5 years in hospital billing/collections experience.
• Ability to sit and work at a computer terminal for extended periods.

Responsibilities

• Validate denial reasons and ensures DCM coding reflects denial reasons.
• Generate an appeal based on dispute reason and contract terms; includes online reconsiderations.
• Follow payer guidelines for appeals submission.
• Escalate exhausted appeal efforts for resolution.
• Work payer projects as directed.
• Research contract terms and compile supporting documents for appeals; IMaCS adjudication issues.
• Determine corrective actions and route accounts accordingly in the DCM system.
• Escalate denial/pvariation trends to NIC leadership.

Skills

EOB understanding

Billing knowledge

ICD-9/HCPCS/CPT coding

Microsoft Office

Communication skills

Education

High School Diploma or equivalent

Some college coursework preferred

Job description

Conifer Health, part of the Tenet family, seeks a disputes specialist to validate denial reasons, prepare appeals, and coordinate with payers to optimize reimbursement. You will work with the Clinical Resource Center for consultations and ensure accuracy in coding for EOB resolutions.

Typical duties include researching contracts, producing supporting documentation, and escalating trends to leadership. Hospital billing experience and strong MS Office skills are essential.