Denials & Appeals Billing Specialist II

DHR Health; Edinburg (TX); On-site; USD 42,000 - 56,000; Full time

Job summary

DHR Health in Edinburg, TX is seeking a Billing and Collections Specialist II in RMF Denials Management, full-time days. The role focuses on QA reviews of denied claims and drafting payer appeals using Official Coding Guidelines and patient records.

Candidates should have 2–3 years in denial management or healthcare billing, strong Excel and EMR workflow knowledge, and bilingual English/Spanish preferred. This position requires attention to detail and timely communications with payers and

Qualifications

• High School Diploma or GED is required.
• 2–3 years of denial management, utilization review or prior authorization in hospital/healthcare.
• Experience in healthcare billing and reimbursement.
• Experience with EMR system workflows.
• Knowledge of CPT/HCPCS, ICD-10 and billing practices.

Responsibilities

• Promote mission and values in service delivery.
• Demonstrate expertise in denials and appeals.
• Draft detailed appeal letters with necessary information.
• Follow up on insurance accounts and manage payer communications.
• Utilize software to verify eligibility and claim status.
• Handle billing and follow-up on claims using billing software.

Skills

Denials management

Appeals drafting

Healthcare billing

EMR workflows

CODING/BILLING knowledge

Microsoft Office

Bilingual English/Spanish

Customer service

Data entry (35 WPM)

Education

High School Diploma/GED

Tools

EMR systems

Microsoft Excel

Billing software

Job description

DHR Health in Edinburg, TX is seeking a Billing and Collections Specialist II in RMF Denials Management, full-time days. The role focuses on QA reviews of denied claims and drafting payer appeals using Official Coding Guidelines and patient records.

Candidates should have 2–3 years in denial management or healthcare billing, strong Excel and EMR workflow knowledge, and bilingual English/Spanish preferred. This position requires attention to detail and timely communications with payers and