Denials Mitigation Specialist I - Hybrid Claims Resolution

MedStar Health; White Marsh (MD); Hybrid; USD 28,000 - 50,000; Full time

Job summary

MedStar Health in Maryland is seeking a Denials Mitigation Specialist for a full-time dayshift with a hybrid schedule (about 3 on-site days per week) and base location in Nottingham, MD. The role involves reviewing technical denials, inpatient and outpatient claims, identifying root causes, and coordinating appeals.

You will manage the denial process, provide monthly status updates, develop training opportunities, and work with Physician Practices, Patient Access, and Hospital Ancillary

Qualifications

• 1–2 years experience in a medical setting with strong insurance knowledge.
• Experience in patient access, prior authorization and denials management preferred.
• Knowledge of CPT/ICD-10 coding and medical terminology.
• Understanding UB04 and Explanation of Benefits (EOB).
• Strong verbal and written communication skills.

Responsibilities

• Manage and resolve denials and appeals ensuring effective denial management and prompt reimbursement.
• Follow up on returned claims, denials account reconciliations and rebills; monitor timely follow up.
• Interpret and apply insurance payer guidelines, claim submission rules and contract terms.
• Collaborate with other departments to ensure proper denial prevention and training.
• Provide monthly updates to Denials Mitigation Supervisor on status and outcomes.

Skills

Verbal and written communication

Medical terminology

CPT/ICD-10 coding

Payer billing

Basic computer skills

Education

High School Diploma or GED

Associate's degree

Job description

MedStar Health in Maryland is seeking a Denials Mitigation Specialist for a full-time dayshift with a hybrid schedule (about 3 on-site days per week) and base location in Nottingham, MD. The role involves reviewing technical denials, inpatient and outpatient claims, identifying root causes, and coordinating appeals.

You will manage the denial process, provide monthly status updates, develop training opportunities, and work with Physician Practices, Patient Access, and Hospital Ancillary