Denials Resolution Specialist - Patient Accounting

0090 Presbyterian System Services; United States; On-site; USD 23,000 - 37,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Disability insurance

Life insurance

Wellness rewards program

Job summary

Presbyterian Healthcare Services in Albuquerque, NM is hiring a Patient Accounting Denials Specialist I. The role handles denial analysis, A/R follow-up, and appeals to overturn denials.

You’ll work in a full-time daytime schedule at Reverend Hugh Cooper Administrative Center, using EHR and payer portals to support accurate claim processing. Required are a high school diploma or GED with insurance-claims training and at least two years in insurance follow-up, billing, and collections.

Qualifications

• High school diploma or GED required with short-term training in insurance collections/claims processing.
• Minimum two years’ experience in insurance follow-up, billing, and collections.
• Excellent communication skills via telephone and written form; strong computer literacy.
• Goal-driven, team player with passion for improving patient experiences and health outcomes.
• Ability to prioritize in a fast-paced environment amid changing payer regulations.

Responsibilities

• Root cause analysis and next-step resolution of denials.
• Accounts receivable follow-up, appeals, and daily reconciliation of activities.
• Denial follow-up for assigned payors using work queues.
• Submit corrected claims, reconsiderations, and/or appeals to overturn denials.
• Provide information (medical records, itemized statements) as needed by insurers.
• Follow procedures to ensure timely follow-up on denials.
• Document accounts per Presbyterian policies and procedures.
• Use EHR, claims clearinghouse, payer portals, and MS Office proficiently.
• Communicate effectively within the team and attend meetings actively.
• Develop professional relationships with team members and external agencies.

Skills

Insurance follow-up

Billing

Collections

Communication skills

Computer literacy

Education

High school diploma or GED

Short-term training on insurance collections

Tools

Electronic Health Records

Claims clearinghouse

FISS/DDE

Payer portals

Microsoft Office

Job description

Presbyterian Healthcare Services in Albuquerque, NM is hiring a Patient Accounting Denials Specialist I. The role handles denial analysis, A/R follow-up, and appeals to overturn denials.

You’ll work in a full-time daytime schedule at Reverend Hugh Cooper Administrative Center, using EHR and payer portals to support accurate claim processing. Required are a high school diploma or GED with insurance-claims training and at least two years in insurance follow-up, billing, and collections.