Denials & Appeals Billing Specialist II

DHR Health; Edinburg (TX); On-site; USD 42,000 - 65,000; Full time

Job summary

DHR Health in Edinburg, TX is seeking a Billing and Collections Specialist II to support denials management in a fast-paced hospital setting. The role emphasizes drafting appeal letters, tracking insurance accounts, and ensuring accurate coding and documentation in patient records.

The ideal candidate has 2-3 years in denial management, healthcare billing experience, and strong Microsoft Office/EMR skills, with English/Spanish bilingualism preferred.

Qualifications

• 2-3 years of experience in denial management, utilization review or prior authorization in a hospital, provider, or healthcare system.
• Experience in healthcare billing and reimbursement.
• Experience with EMR system workflows.
• Knowledge of claim forms and remittance advice, including coding and billing practices.
• Ability to interpret contract language.
• Working knowledge of medical terminology.

Responsibilities

• Draft detailed appeal letters with all necessary information and manage follow-up on assigned insurance accounts.
• Verify eligibility and claim status using payer websites and billing software.
• Review denials weekly for trends and notify appropriate staff of issues.
• Ensure patient confidentiality per HIPAA and maintain accurate notes in the host system.
• Collaborate with internal teams to resolve denials efficiently and address payer policies.

Skills

Denials handling

Customer service

Communication

Bilingual English/Spanish

Education

High School Diploma/GED

Tools

EMR system workflows

Microsoft Office Suite

Excel

Job description

DHR Health in Edinburg, TX is seeking a Billing and Collections Specialist II to support denials management in a fast-paced hospital setting. The role emphasizes drafting appeal letters, tracking insurance accounts, and ensuring accurate coding and documentation in patient records.

The ideal candidate has 2-3 years in denial management, healthcare billing experience, and strong Microsoft Office/EMR skills, with English/Spanish bilingualism preferred.