Denials & Appeals Specialist – Patient Financial Services

Alameda Health Sytem; Oakland (CA); On-site; USD 45,000 - 64,000; Part time

Job summary

Alameda Health System in Oakland, CA is seeking a part-time Patient Financial Services Denial Specialist internal only. The role validates dispute reasons, reviews EOBs, escalates payment variance trends to management, and generates appeals for denied and/or underpaid claims.

DUTIES include escalating denials, following payer guidelines and timelines, compiling documentation, ensuring accurate EHR coding, and coordinating with Revenue Integrity, HIM and ancillary departments as needed.

Qualifications

• Minimum 3–5 years in hospital billing/collections.
• Strong ability to manage multiple work queues daily.
• Ability to analyze trends and report to leadership.

Responsibilities

• Validate denial reasons and ensure accurate EHR coding.
• Escalate denial trends to management for payer escalation.
• Generate appeals per payer guidelines and timelines.
• Research contract terms and supporting docs for appeals.
• Coordinate with Revenue Integrity, HIM and ancillary departments.
• Work payer projects as directed.
• Perform data collection and report payer relations insights.
• Handle patient charges, payments and adjustments in a deadline-driven environment.
• Follow up on exhausted appeal efforts for resolution.

Skills

Excel

Word

Zoom

Communication

Education

High school diploma/GED

Job description

Alameda Health System in Oakland, CA is seeking a part-time Patient Financial Services Denial Specialist internal only. The role validates dispute reasons, reviews EOBs, escalates payment variance trends to management, and generates appeals for denied and/or underpaid claims.

DUTIES include escalating denials, following payer guidelines and timelines, compiling documentation, ensuring accurate EHR coding, and coordinating with Revenue Integrity, HIM and ancillary departments as needed.