Denials Representative -Full-Time

Holy Name Medical Center; Hackensack (NJ); On-site; USD 30,000 - 34,000; Full time

Benefits offered by this job

Medical coverage

Dental and vision plans

401(k) matching

Tuition reimbursement

Paid time off

Job summary

Holy Name Medical Center in Hackensack, NJ is seeking a Denials Representative to investigate, appeal, and resolve denied or underpaid insurance claims to maximize reimbursement. You will work with coding, patient access, utilization management, case management, and billing teams to resolve issues and improve processes.

The role requires 1–3 years of hospital billing and denials experience with knowledge of payer policies, ICD-10-CM, CPT, and HCPCS. A Bachelor’s Degree is preferred.

Qualifications

• Bachelor’s Degree preferred for the role.
• 1–3 years hospital billing and denials experience required.
• Coding experience is preferred.
• Strong analytical, problem-solving, and attention to detail.
• Working knowledge of Medicare, Medicaid, and payer guidelines.
• Familiarity with ICD-10-CM, CPT, HCPCS concepts.

Responsibilities

• Review and investigate denied and underpaid insurance claims to determine non-payment causes.
• Research patient accounts using medical records, coding, documentation, authorizations, and payer guidelines.
• Prepare, submit, and monitor appeals in accordance with payer requirements and deadlines.
• Communicate with insurance companies to resolve claim issues and obtain reimbursement.
• Collaborate with coding, patient access, utilization management, case management, and billing teams to resolve denials.
• Document account activity and maintain accurate records in the patient accounting system.
• Monitor denial inventory and ensure timely follow-up through final resolution.
• Identify denial trends and suggest process improvements to reduce future denials.
• Stay updated on payer policies, billing regulations, and reimbursement guidelines.
• Assist with audits, quality improvement initiatives, and revenue cycle projects.
• Ensure compliance with HIPAA and hospital policies.

Skills

Analytical skills

Attention to detail

Medicare/Medicaid knowledge

Medical terminology & coding concepts

EOB interpretation

EHRs and billing systems

Communication skills

Multitasking

Professionalism

Education

Bachelor's Degree Preferred

Job description

Location: Hackensack, NJ, United States
Date Posted: Aug 18, 2026

Welcome to Holy Name, a medical center where innovation is not just a goal — it's a commitment. Here, medical excellence thrives, allowing hope to reign supreme and leaving no room for fear. At our hospital, every patient is cared for with undivided attention — because healing every soul is our sole focus.

Holy Name is New Jersey's only independent Catholic health system, comprising a 361-bed acute care hospital, a renowned cancer center, a state-of-the-art fitness center, a residential hospice, a prestigious nursing school, and an extensive physician network. Healing at Holy Name goes beyond medicine and technology – it is infused with faith, conviction, compassion, and a commitment to educating the next generation of healthcare professionals through a variety of residency and educational programs. Our mission to provide care for the body, mind, and soul spans education, prevention, diagnosis, treatment, rehabilitation, and overall wellness. This is at the core of who we are and what we do, and we've done it this way across generations, every single day, for nearly 100 years. Every innovation, medical breakthrough, and groundbreaking treatment is powered by some of the best minds in medicine, ensuring nothing is left on the table or the road to recovery.

A Brief Overview

The Denials Representative is responsible for investigating, appealing, and resolving denied or underpaid insurance claims to maximize reimbursement. This position collaborates with internal departments and insurance payers to resolve claim issues, identify denial trends, and support process improvements that strengthen the hospital's revenue cycle.

What you will do

• Review and investigate denied and underpaid insurance claims to determine the cause of non-payment
• Research patient accounts using medical records, coding, documentation, authorizations, and payer guidelines
• Prepare, submit, and monitor appeals in accordance with payer requirements and filing deadlines
• Communicate with insurance companies to resolve claim issues and secure appropriate reimbursement
• Collaborate with coding, patient access, utilization management, case management, and billing teams to resolve denials
• Document account activity and maintain accurate records within the patient accounting system
• Monitor assigned denial inventory and ensure timely follow-up through final resolution
• Identify denial trends and recommend process improvements to reduce future denials
• Maintain current knowledge of payer policies, billing regulations, and reimbursement guidelines
• Assist with audits, quality improvement initiatives, and other revenue cycle projects
• Comply with HIPAA, hospital policies, and all applicable federal and state regulations

Education Qualifications

• Bachelor’s Degree Preferred

Experience Qualifications

• 1 -3 Years Hospital billing and Denials experience required
• Coding experience preferred

Knowledge, Skills, and Abilities

Strong analytical, problem-solving, and critical thinking skills

Excellent attention to detail, organization, and time management

Working knowledge of Medicare, Medicaid, managed care, and commercial insurance reimbursement

Familiarity with medical terminology and coding concepts, including ICD-10-CM, CPT, and HCPCS

Ability to interpret EOBs, remittance advice, payer policies, and reimbursement guidelines

Experience with electronic health records (EHRs), patient accounting systems, and payer portals

Effective verbal and written communication skills with the ability to collaborate across departments and with insurance representatives

Ability to manage multiple priorities, work independently, and meet deadlines in a fast-paced environment

Commitment to professionalism, customer service, confidentiality, and continuous process improvement

At Holy Name, we believe in rewarding every team member with more than a paycheck—we invest in your future and well-being. Full-time and part-time employees have access to a comprehensive benefits package designed to support your health, financial security, and quality of life. We offer low-cost medical coverage with generous employer contributions, dental and vision plans, discounted prescriptions, and access to on-site child care. Additional benefits include 401(k) matching, tuition reimbursement, paid time off, flexible spending accounts, legal and voluntary coverage options, life insurance, and free on-site parking. If you are hired at Holy Name, your final base compensation will be determined based on factors such as employment status (Full/Part-Time or Per Diem) skills, education, and/or experience. In addition to those factors – we believe in the importance of pay equity and consider any internal equity of our current team members as a part of any final offer. Pay Range: $22.00/hour - $25.30/hour


Holy Name is a mission-driven facility whose quality standards and philosophy are rooted in the principles of its founders, the Sisters of St. Joseph of Peace. Those principles are exercised daily by the Medical Center's dedicated and talented staff members. Holy Name is an Equal Opportunity Employer.