Denials Management & Payer Appeals Specialist

McLaren Health Care; Shelby Township (MI); On-site; USD 55,000 - 75,000; Full time

Job summary

McLaren Health Care is seeking a Denials Management Specialist to manage timely follow-up and appeals of denials from third-party payers. You will work independently to ensure deadlines are met and maximize pay for services rendered.

The role requires 7 years in Patient Accounting or Patient Access, or an Associates Degree with 3 years of related experience, with a standard schedule of 8am–4:30pm, on-site in Michigan. Collaborative work with billing teams is essential to improve A/R outcomes.

Qualifications

• High School Diploma or GED required.
• 7 years of experience in Patient Accounting or Patient Access.
• Alternatively, an Associates Degree with 3 years of Patient Accounting or Patient Access experience.

Responsibilities

• Follow up on denials and appeals to meet payer filing deadlines.
• Monitor denial work queues and maintain productive workflow.
• Investigate denial trends and root causes; report findings.
• Assist with claim audits and remedial actions as needed.
• Obtain retro authorizations and submit to payers for reimbursement.
• Work with other departments to resolve A/R and payer issues.
• Participate in meetings to discuss A/R processes and trends.

Education

High School Diploma or GED

Associates Degree

Job description

McLaren Health Care is seeking a Denials Management Specialist to manage timely follow-up and appeals of denials from third-party payers. You will work independently to ensure deadlines are met and maximize pay for services rendered.

The role requires 7 years in Patient Accounting or Patient Access, or an Associates Degree with 3 years of related experience, with a standard schedule of 8am–4:30pm, on-site in Michigan. Collaborative work with billing teams is essential to improve A/R outcomes.