At SCP Health, you have an opportunity to make a difference by helping hospitals and healthcare providers achieve clinical effectiveness. SCP Health serves over 8 million patients and operates in 30 states across 400 healthcare facilities.
This role involves reviewing accounts receivable daily by payer to maintain reimbursement goals, preparing appeals for medical necessity and other denials, providing feedback on payer behavior, resolving claim denial issues including coding and billing errors, and achieving high quality assurance audit scores.
The specialist collaborates with coding and billing teams to address denial root causes, stays current on insurance policies affecting emergency room and hospital medicine services, and meets production standards.
Knowledge in medical coding (ICD-9, ICD-10, CPT, HCPCS), claims processing, and billing software is important. The role requires strong communication skills, meticulous organization, and the ability to work effectively in a team.
Primary location: Dallas, TX, with a hybrid schedule onsite four days per week and remote one day per week.
- Minimum high school diploma or equivalent
- 2+ years of experience in medical insurance denials management
- 2+ years experience in medical patient billing and customer service
- Knowledge of medical coding and claims processing (ICD-9, ICD-10, CPT, HCPCS)
- Ability to read Explanation of Benefits and understand various payer types
- Proficiency with MS Office, especially Excel and Word
- Familiarity with billing systems such as OnBase, Centricity, Way Star, and Payor Portals is a plus
- Strong problem-solving skills and professional communication abilities
- Comprehensive medical, dental, and vision insurance
- 401(k) plan with company match
- Paid time off and holidays
- Professional development support
- Employee wellness resources
- Commitment to work/life balance and inclusive culture
Location
Dallas, Texas, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
2 weeks ago