Denials Resolution Representative

Staffmark Group; Knoxville (TN); On-site; USD 20,000 - 28,000; Full time

Benefits offered by this job

Competitive Weekly Pay

Medical, dental, and vision benefits

Optional 401(k) Plan

Life Insurance and Disability

Job summary

Staffmark Group seeks a Denials Resolution Representative in Knoxville, TN to review and resolve declined medical claims, research denials, and obtain carrier information. This role emphasizes communication with supervisors and cross-functional teams to improve denial resolution processes.

The ideal candidate has at least 2 years of medical billing experience, knowledge of ICD-10/CPT-4, and strong organizational and communication skills.

Qualifications

• Minimum 2 years of medical billing experience.
• Familiarity with ICD-10 and CPT-4 coding.
• Excellent verbal and written communication skills.

Responsibilities

• Review ETM worklists and process claim rejections according to established procedures.
• Research denied and rejected claims and obtain carrier information.
• Identify denial trends and report carrier issues to management.
• Route provider-related rejections to the Provider Enrollment Department.
• Maintain knowledge of the ETM system and denial resolution processes.
• Communicate with supervisors regarding unusual claims, adjustments, and denials.
• Participate in monthly department meetings.
• Perform additional duties as assigned.

Skills

Communication skills

Computer skills

Organization

Education

High school diploma or GED

Tools

CRM software

ETM system

Job description

Now hiring for a Denials Resolution Representative

Location: Knoxville, TN

Pay Rate: $17.28 per hour

Monday - Friday | 8:00 AM - 5:00 PM

Got People Skills? Turn Them Into Paychecks

Looking for Denials Resolution Representative jobs in Knoxville where great communication makes a real difference? This opportunity lets you assist customers, solve problems, and build positive relationships while helping deliver outstanding service every day.

Education Requirements

• High school diploma or GED required.
• Additional customer service, business, or office training is beneficial.

Experience Requirements

• Minimum 2 years of medical billing experience required
• Experience with claim denials and Accounts Receivable preferred
• Knowledge of physician billing and healthcare reimbursement guidelines
• Familiarity with ICD-10 and CPT-4 coding
• Strong computer, organizational, and follow-up skills
• Excellent verbal and written communication skills

Job Duties

• Review ETM worklists and process claim rejections according to established procedures
• Research denied and rejected claims and obtain carrier information
• Identify denial trends and report carrier issues to management
• Route provider-related rejections to the Provider Enrollment Department
• Maintain knowledge of the ETM system and denial resolution processes
• Communicate with supervisors regarding unusual claims, adjustments, and denials
• Participate in monthly department meetings
• Perform additional duties as assigned

Preferred Qualifications

• Previous customer service, call center, retail, office support, or administrative experience is preferred.
• Experience working with CRM software, order processing systems, or customer databases is beneficial.
• Bilingual communication skills may be considered an asset depending on the position.
• Individuals who demonstrate patience, professionalism, adaptability, and excellent communication skills are well positioned for success as a Denials Resolution Representative.

Physical Capabilities

• Ability to remain seated or stand for extended periods while assisting customers.
• Frequent use of computers, telephones, and standard office equipment.
• Ability to communicate clearly with customers, coworkers, and business partners.
• Ability to perform repetitive keyboard and data entry tasks throughout the workday.

Benefits

• Competitive Weekly Pay
• Comprehensive Benefits including medical, dental, and vision coverage.
• Life Insurance and Disability Insurance for added peace of mind.
• Optional 401(k) Plan to help you prepare for the future.
• Supportive Team Environment focused on professional growth and customer success.

"The recruiter I worked with was very nice and understanding. They helped me find the job that was best for me." Staffmark Associate

About Us

At Staffmark, we connect hardworking people with great companies, creating opportunities that make a lasting impact.

Staffmark is an equal opportunity employer. All applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other legally protected status. Staffmark offers reasonable accommodations for qualified individuals with disabilities; contact your local branch for inquiries. Staffmark is an E-Verify employer. See our Privacy Notice for Candidates and Employees/Contractors at https://smgroupna.com/privacy-notice-for-candidates-and-employees-contractors. By applying, you consent to receive AI-generated and non-AI-generated calls, texts, or emails from Staffmark Group, its affiliates, and partners. Frequency varies and message/data rates may apply. Reply STOP to cancel or HELP for help.