Denials & Appeals Strategist

Hamilton County Hospital District; Hamilton (TX); On-site; USD 55,000 - 75,000; Full time

Job summary

Hamilton County Hospital District is seeking an experienced Revenue Cycle Specialist to review, resolve, and track claim denials and appeals across hospital and clinic services. You will analyze variances, pursue recoveries, communicate findings to leadership, and work with clinical and administrative teams to prevent future denials.

This role requires knowledge of payer requirements, EOBs, and credentialed billings; proficiency with Excel, EHR systems, and payer portals; and the ability to

Qualifications

• Knowledge of hospital billing, payer requirements, EOBs and electronic remittance advice, claim adjustment and remark codes, and appeal processes.
• Proficiency with Excel, electronic health records, clearinghouse work queues, and payer portals.
• Ability to analyze trends, organize deadlines, document findings, and communicate effectively with clinical and administrative teams.

Responsibilities

• Review, resolve, and track assigned claim denials and appeals.
• Identify recurring denial causes and coordinate prevention efforts.
• Review payment variances against payer contracts; pursue recovery and report discrepancies.
• Work may include inpatient, swing bed, surgery, outpatient, ED, rural health clinic, and professional claims across payers.

Skills

Hospital billing knowledge

Payer requirements understanding

Analytical thinking

Communication skills

Deadline management

Education

High school graduate or equivalent

Associate degree or coursework in healthcare administration, business, medical billing, or related field

Tools

Excel

Electronic Health Records (EHR)

Clearinghouse queues

Payer portals

Job description

Hamilton County Hospital District is seeking an experienced Revenue Cycle Specialist to review, resolve, and track claim denials and appeals across hospital and clinic services. You will analyze variances, pursue recoveries, communicate findings to leadership, and work with clinical and administrative teams to prevent future denials.

This role requires knowledge of payer requirements, EOBs, and credentialed billings; proficiency with Excel, EHR systems, and payer portals; and the ability to