Denials Management Specialist

Jobtailor; Montgomery (AL); On-site; USD 42,000 - 62,000; Full time

Job summary

Jobtailor is seeking a billing and collections professional in Montgomery, AL to validate disputes, generate appeals, and resolve aged accounts through research of billing rules and regulations.

The role requires 3+ years in hospital billing or a related setting, with knowledge of ICD-9/10 and CPT coding, and a preference for CRCR/CPAR certification. Strong MS Office skills and familiarity with billing software are essential.

Qualifications

• High school diploma or equivalent required.
• 3+ years in hospital billing or collections.
• CRCR or CPAR certification preferred.
• Strong MS Office skills and familiarity with billing software.
• Knowledge of ICD-9, ICD-10, and CPT coding.

Responsibilities

• Validate dispute reasons and elevate payment variance trends to management.
• Generate appeals for denied or underpaid claims.
• Resolve complex and aged accounts through research of regulations and billing rules.
• Provide feedback to Managed Care and Revenue Integrity teams.
• Document all pertinent collection activities thoroughly.

Skills

Analytical skills

Problem solving

MS Office

Billing & collections

Regulatory compliance

Education

High school diploma or equivalent

Associates degree or higher

Tools

Billing software

Job description

Responsibilities

• Validate dispute reasons and elevate payment variance trends to management.
• Generate appeals for denied or underpaid claims.
• Resolve complex and aged accounts through research of regulations and billing rules.
• Provide feedback to Managed Care and Revenue Integrity teams.
• Document all pertinent collection activities thoroughly.

Requirements

• High School diploma or equivalent required.
• Associates degree or higher preferred.
• Minimum of at least 3 years’ experience in a hospital business or medical office environment performing billing and/or collections.
• CRCR or CPAR certification preferred.
• Excellent knowledge of MS Office and familiarity with relevant computer software.
• Strong analytical and problem-solving ability.
• Knowledge of ICD-9, ICD-10, and CPT coding.

Core Competencies

Demonstrates expertise in billing and collections within a hospital or medical office environment, with a strong focus on regulatory compliance and coding standards. Proficient in analyzing payment variances and generating appeals for denied claims.