Medical Denials Specialist - Claims & Appeals Expert

Carolina Nephrology; Greenville (SC); On-site; USD 25,000 - 29,000; Full time

Benefits offered by this job

401(k)

Paid Holidays

PTO

Dental/Health/Vision Insurance

Job summary

Carolina Nephrology in Greenville, SC seeks an experienced Medical Denials Specialist to manage denied and outstanding professional claims across multiple queues. The role requires thorough claim research, corrective action, and timely documentation to support reimbursement.

In-office position with a Monday–Friday schedule and competitive hourly pay. Applicants should have a minimum of three years in medical denial management, knowledge of eligibility, and the ability to read EOBs/ERAs.

Qualifications

• Minimum of three years of direct medical denial management experience.
• Knowledge of health insurance eligibility and coordination of benefits.
• Ability to read and interpret EOBs/ERAs and determine appropriate action.
• Strong communication, organization, and time-management skills.
• Experience with payer portals and denial-related communications.

Responsibilities

• Research and resolve denied claims by identifying root causes and submitting appeals.
• Monitor filing deadlines and follow up on appeals and disputes.
• Review payer communications and denial information to determine next steps.
• Document denial research and actions in the patient account for follow-up.
• Answer patient billing questions and assist with billing-related inquiries.

Skills

Medical Denials

Denial Research

Payer Portals

Epic Experience

Team Player

Education

High School Diploma

Job description

Carolina Nephrology in Greenville, SC seeks an experienced Medical Denials Specialist to manage denied and outstanding professional claims across multiple queues. The role requires thorough claim research, corrective action, and timely documentation to support reimbursement.

In-office position with a Monday–Friday schedule and competitive hourly pay. Applicants should have a minimum of three years in medical denial management, knowledge of eligibility, and the ability to read EOBs/ERAs.