Patient Denials Specialist I – A/R Resolution & Appeals

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

Benefits offered by this job

Wellness program

Comprehensive benefits

Job summary

Presbyterian Healthcare Services is hiring a Patient Accounting Denials Specialist I to perform denial follow-up and appeals in the Business-Office Physician Services. You will support A/R processes, gather records, and maintain compliance with HIPAA and CMS regulations.

The role emphasizes teamwork, detailed documentation, and effective communication across payors and departments, with a full-time day shift at Reverend Hugh Cooper Administrative Center.

Qualifications

• Two years of experience in insurance follow-up, billing, and collections.
• Strong communication via telephone and in writing; computer literate.
• Experience with Microsoft Office Suite preferred; detail-oriented and organized.
• Ability to prioritize; work well in a team and maintain confidentiality.

Responsibilities

• Perform denial follow-up for assigned payors using work queues.
• Submit corrected claims, reconsiderations, and/or appeals to overturn denials.
• Provide requested records (medical notes, itemized statements) to process claims.
• Follow procedures to ensure timely follow-up on denials.
• Document accounts per Presbyterian Health policies and procedures.
• Utilize EHR, clearinghouse, payer portals, and Microsoft Office tools.
• Communicate effectively within the team and participate in meetings.
• Develop professional relationships with team, departments, and outside agencies.
• Maintain confidentiality per HIPAA and CMS rules.

Skills

Communication

Teamwork

Microsoft Office

HIPAA compliance

Education

High school diploma or GED

Tools

Electronic Health Record (EHR)

Payer portals

FISS/DDE

Claims clearinghouse

Job description

Presbyterian Healthcare Services is hiring a Patient Accounting Denials Specialist I to perform denial follow-up and appeals in the Business-Office Physician Services. You will support A/R processes, gather records, and maintain compliance with HIPAA and CMS regulations.

The role emphasizes teamwork, detailed documentation, and effective communication across payors and departments, with a full-time day shift at Reverend Hugh Cooper Administrative Center.