Denials & Appeals Specialist - Medical Billing

Southwoods Health; Boardman Township (OH); On-site; USD 42,000 - 64,000; Full time

Job summary

Southwoods Health in Boardman, Ohio is hiring a Denials Management Specialist to handle correspondence with insurers, follow up on unpaid or denied claims, and drive timely payments through the appeals process. You will review denial worklists, contact carriers, file appeals with supporting documentation, and log all interactions in patient records, while maintaining regulatory compliance.

Strong communication, problem-solving, and knowledge of revenue cycle operations are essential;

Qualifications

• Completed training or courses in business office operations, computer applications, and medical terminology.
• Certification in collection or billing is highly preferred.
• Comprehensive knowledge of revenue cycle operations and resolving complex claim issues.

Responsibilities

• Review tasks, credit balances, and denial worklists on a daily/weekly basis.
• Contact insurance companies to determine the status of unpaid or denied accounts.
• Prepare, file, and submit formal insurance appeals with necessary documentation.
• Document all contact interactions in patient account records.
• Identify billing errors and report for policy corrections.
• Stay compliant with OSHA, ODH, BOP, TJC and related regulations.

Skills

Communication skills

Problem solving

Professional demeanor

Ethical conduct

Education

Business office operations training

Medical terminology training

Computer applications training

Tools

Billing software

Job description

Southwoods Health in Boardman, Ohio is hiring a Denials Management Specialist to handle correspondence with insurers, follow up on unpaid or denied claims, and drive timely payments through the appeals process. You will review denial worklists, contact carriers, file appeals with supporting documentation, and log all interactions in patient records, while maintaining regulatory compliance.

Strong communication, problem-solving, and knowledge of revenue cycle operations are essential;