Full-time day shift position with a hybrid work schedule, requiring approximately 3 days on-site per week.
The Denials Mitigation Specialist provides ongoing review of technical denials for inpatient and outpatient claims, determines root causes, identifies training needs, evaluates appeal options, and manages the technical appeals process. This role also handles complex appeal responses, supports reimbursement error prevention efforts, and works closely with multiple internal departments and managed care partners to improve denial resolution and reimbursement outcomes.
Requirements & Qualifications
Qualifications
- High school diploma or GED required; associate degree preferred
- 1-2 years of experience in a medical setting with strong insurance knowledge and medical coding
- Patient access, prior authorization, and denials management experience preferred
- CHAA, CHAM, or CRCS preferred
- Knowledge of medical terminology and CPT/ICD-10 coding
- Basic knowledge of UB04 and Explanation of Benefits (EOB)
- Working knowledge of payer applications, billing, and/or collection processes
- Strong verbal and written communication skills
- Basic computer skills preferred
Location
Baltimore, Maryland, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 month ago