Denials & Appeals Billing Specialist

DHR Health; Edinburg (TX); On-site; USD 40,000 - 65,000; Full time

Job summary

DHR Health in Edinburg, TX is seeking a Billing and Collections Specialist in RMF Denials Management. You will review denied claims, draft payer appeals using clinical indicators and coding guidelines, and support the Revenue Cycle team.

The role requires 0-2 years in denial management, familiarity with CPT/HCPCS/ICD-10, and strong Microsoft Office skills. Bilingual English/Spanish is preferred. Join us to improve patient service and ensure compliant, timely reimbursements.

Qualifications

• High School Diploma or GED required.
• 0–2 years in denial management, utilization review or related area in a hospital, provider, or healthcare system.
• Experience with EMR workflows and healthcare billing.
• Knowledge of ICD-10, CPT/HCPCS, and remittance advice; able to interpret contract language.

Responsibilities

• Draft appeal letters with all necessary information for payer review.
• Follow up on assigned insurance accounts and manage denial resolutions.
• Adhere to governmental billing and collection rules as outlined in manuals.
• Utilize software to verify eligibility and claim status; document notes in the host system.
• Respond to insurance carrier correspondence in a timely manner.

Skills

Denials management

Healthcare billing

Customer service

Bilingual English/Spanish

Education

High School Diploma/GED

Tools

Microsoft Office Suite

Job description

DHR Health in Edinburg, TX is seeking a Billing and Collections Specialist in RMF Denials Management. You will review denied claims, draft payer appeals using clinical indicators and coding guidelines, and support the Revenue Cycle team.

The role requires 0-2 years in denial management, familiarity with CPT/HCPCS/ICD-10, and strong Microsoft Office skills. Bilingual English/Spanish is preferred. Join us to improve patient service and ensure compliant, timely reimbursements.