Insurance Denials Coordinator

Urology Centers of Alabama; Homewood (IL); On-site; USD 52,000 - 70,000; Full time

Job summary

Urology Centers of Alabama is seeking an Insurance Denials Coordinator to manage and resolve denied claims, analyze trends, and work with billing, coding, and clinical teams to improve reimbursement. The role focuses on preparing appeals, gathering documentation, and ensuring timely, compliant denial resolution.

The ideal candidate has 2–5 years of medical billing or denial management experience, familiarity with Medicare/Medicaid and commercial payers, and proficient use of EHR systems and

Qualifications

• Denial management and reimbursement workflows.
• Experience with payer policies and regulatory guidelines.
• Experience with medical billing and claims processing is expected.
• Familiarity with CPT, HCPCS, ICD-10 coding and EHR systems.

Responsibilities

• Review and investigate denied, rejected, or underpaid insurance claims.
• Identify denial trends, root causes, and opportunities for process improvement.
• Prepare and submit first-level and second-level appeals within payer deadlines.
• Gather supporting documentation required for appeals, including medical records, authorizations, and physician notes.
• Contact insurance carriers to obtain claim status updates and resolve claim discrepancies.
• Collaborate with coding, billing, clinical, and registration departments to correct claim issues.
• Monitor denial work queues and prioritize accounts based on aging and financial impact.
• Track appeal outcomes and reimbursement activity.
• Ensure compliance with payer policies, Medicare, Medicaid, and commercial insurance guidelines.
• Maintain accurate documentation of claim activity and communications within billing systems.
• Analyze recurring denial patterns and recommend corrective action plans.
• Provide monthly denial reports and KPIs to management.
• Assist with revenue recovery initiatives and special projects.
• Stay current on insurance regulations, coding updates, and reimbursement changes.

Skills

Denial management

Revenue cycle knowledge

Data analysis

Communication skills

EHR systems

CPT/HCPCS knowledge

Education

High School Diploma or GED

Associate's degree preferred

Tools

Microsoft Office Suite

Job description

Job DetailsPosition Summary

The Insurance Denials Coordinator is responsible for managing, analyzing, and resolving insurance claim denials to ensure timely reimbursement and optimize revenue cycle performance. This role works closely with insurance carriers, providers, billing teams, coding specialists, and patients to research denied claims, identify root causes, submit appeals, and ensure compliance with payer requirements and regulatory guidelines.

Essential Duties and Responsibilities

• Review and investigate denied, rejected, or underpaid insurance claims.
• Identify denial trends, root causes, and opportunities for process improvement.
• Prepare and submit first-level and second-level appeals within payer deadlines.
• Gather supporting documentation required for appeals, including medical records, authorizations, and physician notes.
• Contact insurance carriers to obtain claim status updates and resolve claim discrepancies.
• Collaborate with coding, billing, clinical, and registration departments to correct claim issues.
• Monitor denial work queues and prioritize accounts based on aging and financial impact.
• Track appeal outcomes and reimbursement activity.
• Ensure compliance with payer policies, Medicare, Medicaid, and commercial insurance guidelines.
• Maintain accurate documentation of claim activity and communications within billing systems.
• Analyze recurring denial patterns and recommend corrective action plans.
• Provide monthly denial reports and key performance indicators (KPIs) to management.
• Assist with revenue recovery initiatives and special projects.
• Stay current on insurance regulations, coding updates, and reimbursement changes.

QualificationsQualifications

Education

• High School Diploma or GED required.
• Associate's degree in Healthcare Administration, Business Administration, Medical Billing and Coding, or related field preferred.

Experience

• 2-5 years of experience in medical billing, claims processing, denial management, or revenue cycle operations.
• Experience working with Medicare, Medicaid, and commercial insurance payers preferred.
• Experience with electronic health records (EHR) and practice management systems preferred.

Knowledge, Skills, and Abilities

• Strong understanding of healthcare reimbursement methodologies.
• Knowledge of CPT, HCPCS, ICD-10, and medical billing processes.
• Understanding of insurance claim adjudication and appeal procedures.
• Proficiency with medical billing software and Microsoft Office Suite.
• Strong analytical and problem-solving skills.
• Excellent written and verbal communication skills.
• Ability to interpret Explanation of Benefits (EOBs) and Remittance Advice documents.
• Strong organizational and time-management skills.
• Ability to meet productivity and collection goals.
• Attention to detail and accuracy.
• Ability to work independently and collaboratively within a team environment.

Physical Requirements

• Prolonged periods of sitting and computer use.
• Ability to communicate effectively by phone and email.