Denials Specialist - Phoenix Arizona

Company: VirtualVocations
Location: Phoenix, Arizona
Posted On: 01/07/2025

A company is looking for a Denials Specialist responsible for validating dispute reasons and generating appeals for denied or underpaid claims.



Key Responsibilities

Validate denial reasons and ensure accurate coding in DCM
Generate appeals based on dispute reasons and payer guidelines
Research contract terms and escalate denial trends to management


Required Qualifications

High School Diploma or equivalent; some college coursework preferred
3 - 5 years of experience in a hospital business environment
Intermediate understanding of Explanation of Benefits (EOB) and Managed Care Contracts
Intermediate knowledge of hospital billing form requirements (UB-04)
Intermediate understanding of ICD-9, HCPCS/CPT coding, and medical terminology More...

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