Denial Management & Appeals Specialist

Iredell Memorial Hospital Incorporated; Statesville (NC); On-site; USD 45,000 - 70,000; Full time

Job summary

Iredell Memorial Hospital Incorporated is seeking a Denial Specialist to manage denials related to authorizations, medical records, and coordination of benefits. You will oversee denial/appeal activity, communicate with stakeholders, and work to maximize reimbursement while minimizing write-offs.

The role requires strong medical billing experience, coding knowledge, and proficiency with payer websites, email, and Microsoft Office.

Qualifications

• 3+ years in a medical billing department with strong AR follow-up, appeals, and coding knowledge.
• Knowledge of professional medical billing, claim processing, follow-up and appeals.
• Proficient in email, internet search, payer websites; MS Office (Outlook, Word, Excel).
• Strong reasoning, critical thinking, analytical and mathematical skills.
• Ability to work independently with deadlines; CPC preferred; Cerner EHR preferred.

Responsibilities

• Review denied claims to ensure coding accuracy and correct as needed.
• Ensure billing and coding are correct before sending appeals or reconsiderations.
• Investigate claims with no payer response to ensure claims were received by payer.
• Communicate denial/appeal activity to stakeholders and escalation points.
• Track follow-up work queues and resolve charge questions.
• Identify missing payments, overpayments, and analyze credits on accounts.
• Deliver timely reports to management and document resolutions.

Skills

AR follow-up

Appeals knowledge

Medical billing

Critical thinking

Analytical skills

Microsoft Excel

Payer websites

Education

High School Diploma or GED

CPC certification preferred

Tools

Cerner EHR

Microsoft Office

Outlook

Excel

Job description

Iredell Memorial Hospital Incorporated is seeking a Denial Specialist to manage denials related to authorizations, medical records, and coordination of benefits. You will oversee denial/appeal activity, communicate with stakeholders, and work to maximize reimbursement while minimizing write-offs.

The role requires strong medical billing experience, coding knowledge, and proficiency with payer websites, email, and Microsoft Office.