Denials & Appeals Specialist - Revenue Integrity

Washington Hospital Healthcare System; Fremont (CA); On-site; USD 69,000 - 100,000; Full time

Job summary

Washington Hospital Healthcare System in Fremont, CA seeks a Billing Denials Specialist to manage end-to-end denial and appeals processes, identify trends, and partner with clinical, coding, billing, and payer-relations staff to protect revenue integrity.

The role requires 2–4 years in medical billing or denial management, knowledge of ICD-10/CPT/HCPCS, and strong written and verbal communication to prepare well-supported appeals and ensure timely filings.

Qualifications

• 2–4 years in medical billing, denial management, or revenue cycle operations.
• Knowledge of ICD-10, CPT, HCPCS, medical terminology, and payer reimbursement.
• Familiarity with Medicare/Medicaid and commercial payer guidelines.
• Proficiency with EHR and practice management/billing systems.

Responsibilities

• Meets or exceeds productivity and turnaround targets for denial resolution and appeal submission.
• Overturns a measurable percentage of denied claims with well-documented appeals.
• Prioritizes workload to meet payer filing deadlines and avoid losses.
• Tracks outcomes and maintains denial status, deadlines, and results.

Skills

Communication skills

Analytical ability

Attention to detail

Team collaboration

Education

Associate's or Bachelor's in Health Information Management / Healthcare Administration

CCS / CPC / CRCR credential a plus

Tools

Epic

Kodiak

Optum360

Availity

Job description

Washington Hospital Healthcare System in Fremont, CA seeks a Billing Denials Specialist to manage end-to-end denial and appeals processes, identify trends, and partner with clinical, coding, billing, and payer-relations staff to protect revenue integrity.

The role requires 2–4 years in medical billing or denial management, knowledge of ICD-10/CPT/HCPCS, and strong written and verbal communication to prepare well-supported appeals and ensure timely filings.