Denials Management & Appeals Specialist

Memorial Health System; Reno (OH); On-site; USD 45,000 - 65,000; Full time

Job summary

Memorial Health System is seeking a Denials Management Coordinator to review denials, identify patterns, and collaborate with frontline staff to improve processes. You will articulate appeals to carriers and document outcomes in the hospital information system.

The role requires strong analytical, negotiation, and communication skills, with experience in coding and medical terminology preferred. A focus on ongoing process improvement and cross-functional teamwork is essential.

Qualifications

• High School Diploma or GED required.
• Experience in healthcare-related position preferred.
• Basic ICD-10 coding, medical terminology, anatomy/pathophysiology knowledge preferred.

Responsibilities

• Analyze denials to identify patterns by payor and process.
• Educate frontline staff on proper processes.
• Verbalize with insurance carriers and write appeal details to support payment on denials.
• Document results of denial reviews in the hospital information system.
• Prepare management-required reports on audit results and process improvements.
• Provide monthly observations and recommendations to prevent future denials.
• Perform other duties as needed.

Skills

Denials analysis

Staff education

Verbal communication

Negotiation

Data/documentation

Team collaboration

Education

High School Diploma or GED

ICD-10 coding knowledge

Coding certification (within 2 years)

Tools

Hospital information systems

Payment review systems

Charge master understanding

Job description

Memorial Health System is seeking a Denials Management Coordinator to review denials, identify patterns, and collaborate with frontline staff to improve processes. You will articulate appeals to carriers and document outcomes in the hospital information system.

The role requires strong analytical, negotiation, and communication skills, with experience in coding and medical terminology preferred. A focus on ongoing process improvement and cross-functional teamwork is essential.