Revenue Cycle Denials & Appeals Specialist

Hamilton Healthcare System; Texas; On-site; USD 55,000 - 75,000; Full time

Job summary

Hamilton Healthcare System is seeking a Denials and Appeals Specialist to review, resolve, and track denials and appeals, identifying recurring causes and coordinating prevention across the revenue cycle.

The role involves analyzing variances against payer contracts and reimbursement methods, pursuing recovery, and communicating unresolved discrepancies to leadership, while maintaining queues and reports to support timely filing and departmental improvement.

Qualifications

• High school diploma or equivalent required; associate degree or coursework preferred.
• Knowledge of hospital billing, payer requirements, EOBs and remittance advice, claim adjustments, and appeals.
• Proficiency with Excel, electronic health records, clearinghouse work queues, and payer portals.
• Ability to analyze trends, organize deadlines, document findings, and communicate with teams.

Responsibilities

• Review, resolve, and track denials and appeals; identify recurring denial causes; coordinate prevention across revenue cycle.
• Review payment variances against payer contracts and methodologies; pursue recovery; inform leadership of unresolved discrepancies.

Skills

Hospital billing

Payer requirements

EOBs and remittance advice

Claim adjustments

Appeal processes

Excel

Electronic health records

Clearinghouse queues

Payer portals

Trend analysis

Deadline management

Documentation of findings

Communication with clinical teams

Education

High school diploma or equivalent

Associate degree or coursework in healthcare administration, business, medical billing, or related field

Tools

Excel

Electronic health records

Clearinghouse work queues

Payer portals

Job description

Hamilton Healthcare System is seeking a Denials and Appeals Specialist to review, resolve, and track denials and appeals, identifying recurring causes and coordinating prevention across the revenue cycle.

The role involves analyzing variances against payer contracts and reimbursement methods, pursuing recovery, and communicating unresolved discrepancies to leadership, while maintaining queues and reports to support timely filing and departmental improvement.