Inpatient Denials & Appeals Specialist

Capital Health (US); New York (NY); On-site; USD 28,000 - 36,000; Full time

Benefits offered by this job

Medical Plan

Retirement Savings Plan

Paid Time-Off

Job summary

Capital Health is seeking an experienced inpatient denials coordinator to manage denials, triage cases, and coordinate appeals with clinical and operational teams.

The role requires 3+ years in hospital billing or denials, plus an education in healthcare or business. Proficiency with EMR, payer portals, and Excel is expected. The position offers a 40-hour work week in New York with a pay range of $20.10–$26.13 per hour for a full-time role.

Qualifications

• Education: High school diploma or equivalent required.
• Experience: Three years’ hospital billing, denials management, utilization review support, or related revenue cycle experience.
• Experience with inpatient clinical denials, patient status determinations, or medical necessity denials preferred.

Responsibilities

• Review and triage inpatient clinical denials across medical necessity, patient status, and readmission-related denials.
• Route cases to appropriate clinical resources based on denial type and appeal viability.
• Maintain accurate inpatient denial inventories with deadlines, appeal levels, and documentation status.
• Coordinate medical record requests, appeal packet preparation, and submission tracking.
• Ensure compliance with payer requirements and timelines for inpatient denials.
• Perform payer follow-up via portal research and telephone outreach.

Skills

Organization skills

Detail oriented

Strong written communication

Root cause analysis

Payer follow-up

Education

High school diploma or equivalent

Associate or bachelor’s degree in healthcare or business-related field

Tools

EMR navigation

Payer portals

Hospital billing systems

Microsoft Excel

Job description

Capital Health is seeking an experienced inpatient denials coordinator to manage denials, triage cases, and coordinate appeals with clinical and operational teams.

The role requires 3+ years in hospital billing or denials, plus an education in healthcare or business. Proficiency with EMR, payer portals, and Excel is expected. The position offers a 40-hour work week in New York with a pay range of $20.10–$26.13 per hour for a full-time role.