Medical Denials Specialist Job at Robert Half (Carmel)

Medical Denials Specialist

We are seeking a detail-oriented Medical Denials Specialist to join our healthca...

Location

United States , Carmel

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
associate or bachelor’s degree preferred
2+ years of experience in medical billing, claims denial management or revenue cycle operations
Strong knowledge of EOBs, ERAs, CPT, ICD-10 and HCPCS codes
Experience with appeals, claim edits and insurance follow-up
Familiarity with Medicare, Medicaid and commercial payer regulations
Proficiency with electronic medical records and billing systems
Strong analytical, organizational and problem-solving skills
Excellent written and verbal communication skills
Ability to manage multiple priorities in a fast-paced environment

Job Responsibility

Review and investigate denied or underpaid medical claims
Identify denial trends and root causes to support process improvement
Prepare and submit claim corrections, reconsiderations and appeals
Follow up with insurance companies regarding claim status and payment resolution
Verify coding, billing and documentation accuracy to ensure compliance with payer requirements
Collaborate with billing, coding, collections and clinical teams to resolve claim issues
Maintain accurate records of denial activity, appeal outcomes and account updates
Monitor payer policy changes and reimbursement guidelines
Meet productivity and quality goals related to denial resolution and accounts receivable follow-up

What we offer

Medical insurance
Vision insurance
Dental insurance
Life insurance
Disability insurance
401(k) plan

Fulltime

Medical Denials Specialist

Join our dynamic healthcare team as a Medical Denials Specialist and play a key ...

Location

United States , Carmel

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
associate’s or bachelor’s degree in healthcare administration or related field preferred
Minimum 2 years’ experience in medical billing, denials management, or health insurance claims
Strong understanding of coding standards (ICD-10, CPT), claims processing, and insurance guidelines
Excellent communication and negotiation skills
Proficiency with medical billing software and EMR systems
Detail-oriented, organized, and adaptable in a dynamic environment

Job Responsibility

Review insurance denial notifications and conduct thorough research to resolve outstanding claims issues
Analyze denial patterns and root causes, recommending process enhancements to prevent future occurrences
Communicate directly with insurance payers to troubleshoot and expedite claim resolutions
Prepare, document, and submit appeals for denied claims
Work closely with billing teams, healthcare providers, and insurance companies to ensure smooth claims management
Stay informed on payer guidelines and current healthcare compliance regulations
Consistently maintain adherence to HIPAA requirements and internal policies

What we offer

medical, vision, dental, and life and disability insurance
company 401(k) plan
free online training

Medical Denials Specialist

Join our fast-paced healthcare team as a Medical Denials Specialist and make a m...

Location

United States , Carmel

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
associate’s or bachelor’s degree in healthcare administration or related field preferred
Minimum 2 years’ experience in medical billing, denials management, or health insurance claims
Strong understanding of coding standards (ICD-10, CPT), claims processing, and insurance guidelines
Excellent communication and negotiation skills
Proficiency with medical billing software and EMR systems
Detail-oriented, organized, and adaptable in a dynamic environment

Job Responsibility

Review insurance denial communications and perform detailed research to address outstanding claims
Identify trends and root causes in denied claims, offering recommendations for process improvements
Liaise directly with insurance payers to resolve claim issues and accelerate resolution
Prepare and submit appeals, including all necessary documentation
Collaborate with billing teams, healthcare providers, and insurance carriers to support effective claims management
Maintain up-to-date knowledge of payer requirements and current healthcare regulations
Ensure all work adheres to HIPAA standards and internal compliance policies

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan
free online training

Claims and Denials Specialist

We are looking for a skilled Claims and Denials Specialist to join our client on...

Location

United States , Oakland

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 2 years of experience in administrative assistance or a related field
Familiarity with home health processes and insurance protocols
Proficiency in handling inbound calls and delivering excellent customer service
Strong organizational skills, particularly in calendar management and scheduling
Expertise in medical insurance verification and claims handling
Knowledge of handling claim denials and insurance appeals
Ability to work effectively in a fast-paced, detail-oriented environment

Job Responsibility

Coordinate insurance authorizations to ensure timely approval for services
Manage incoming calls professionally, providing accurate information and addressing inquiries
Oversee scheduling and calendar management to optimize workflow and appointments
Process claims and address denials, working closely with insurance providers to resolve issues
Handle appeals and payment posting with precision and attention to detail
Verify medical insurance coverage and eligibility for patients
Collaborate with healthcare professionals and administrative teams to facilitate seamless operations
Maintain comprehensive records of insurance claims and denials for auditing and reporting purposes
Provide administrative support to enhance efficiency in daily tasks and operations

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

New

Medical Collections Specialist

We are looking for a Medical Collections Specialist to join a healthcare team in...

Location

United States , Sacramento

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience in medical collections, accounts receivable follow-up, or healthcare reimbursement functions
Strong understanding of Explanation of Benefits documents and insurance claim adjudication processes
Knowledge of patient financial responsibility concepts, including copays, deductibles, coinsurance, and out-of-pocket maximums
Familiarity with commercial insurance plans, PPO products, and Medicare Advantage reimbursement structures
Proven ability to write effective appeals for denied or underpaid medical claims
Confidence interacting with both insurance representatives and patients regarding account balances and claim outcomes
Ability to manage a high-volume workload, stay organized under pressure, and consistently achieve performance targets
Working knowledge of medical terminology and revenue cycle processes related to claim denials and reimbursement

Job Responsibility

Review payer contracts and reimbursement terms to determine correct allowed amounts and identify underpayments
Interpret Explanation of Benefits statements to evaluate claim decisions and confirm financial responsibility
Investigate denied, delayed, or partially paid claims and take appropriate action to secure proper reimbursement
Prepare clear, persuasive appeals that address payer findings and support claim reconsideration
Communicate with insurance carriers to resolve billing discrepancies, payment issues, and adjudication concerns
Speak with patients regarding outstanding balances, explaining how copays, deductibles, coinsurance, and out-of-pocket limits affect what they owe
Maintain consistent follow-up on assigned accounts while meeting productivity expectations in a fast-moving workload
Apply analytical judgment to determine the most effective next steps for account resolution and escalation when needed
Collaborate with team members to support collection goals and maintain quality standards across account follow-up activities

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

New

Medical Billing Specialist

Our nonprofit client is seeking a Medical Billing Specialist to manage medical b...

Location

United States , Salinas

Salary:

30.00 - 50.00 USD / Hour

Robert Half

Expiration Date

Until further notice

Requirements

Associate’s degree in Health Information Technology, Healthcare Administration, Billing/Coding, or a related field
or equivalent combination of education and directly related experience
At least 2 years of experience in medical billing, preferably including Medicaid/Medi-Cal or other public payer billing
Working knowledge of standard billing practices, including CPT/HCPCS and ICD-10 coding
Ability to read and interpret payer bulletins, remittance advice, and denial codes
High level of accuracy, attention to detail, and follow-through
Strong organizational and time-management skills with the ability to manage multiple priorities and deadlines
Clear written and verbal communication skills with clinical and non-clinical staff
Ability to work independently and collaboratively in a team-oriented environment
Proficiency with Microsoft Office or Google Workspace, including word processing, spreadsheets, email, and shared drives

Job Responsibility

Prepare, submit, and track electronic and paper claims to public and private payers, ensuring accurate coding and required documentation
Monitor claim status, resolve denials and underpayments, and resubmit corrected claims as needed
Post payments and adjustments, reconcile remittance advice, and maintain accurate billing records
Review service notes and encounter documentation for completeness, clarity, and compliance with payer and program standards
Communicate with program and administrative staff regarding documentation requirements, billing timelines, and follow-up items
Maintain organized and secure electronic records in billing, EHR, and related systems
Assist with internal billing audits, quality assurance initiatives, and preparation for external monitoring or reviews
Ensure billing practices align with payer, contract, and regulatory requirements, including timely filing limits
Support preparation of reports related to service utilization, revenue, and billing activity
Protect all client information in accordance with HIPAA and applicable privacy regulations

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

New

Medical Biller/Collections Specialist

We are looking for a detail-oriented Medical Biller/Collections Specialist to su...

Location

United States , Philadelphia

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Prior experience in medical billing, medical collections, denials, appeals, or hospital billing is preferred
Proficiency with Microsoft Excel and Word, including the ability to manage spreadsheets and organize documentation
Strong data entry skills with close attention to accuracy and completeness
Ability to balance multiple tasks effectively and adapt to shifting priorities throughout the day
Excellent organizational skills and the ability to handle administrative responsibilities in a structured manner
Experience working in a healthcare environment is an advantage
Familiarity with Navinet or similar healthcare payer tools is a plus

Job Responsibility

Provide day-to-day administrative assistance to the billing and reimbursement team to help keep departmental workflows running smoothly
Prepare, scan, print, and review billing documents to ensure information is complete, accurate, and ready for processing
Build, maintain, and update Excel spreadsheets and other tracking tools used for departmental reporting and recordkeeping
Sort incoming mail, distribute correspondence to the appropriate team members, and coordinate outgoing billing-related mailings
Investigate returned mail, verify patient or account details, and update internal records to reflect corrected information
Send patient statements and secondary claim documentation in a timely manner while supporting follow-up on outstanding items
Enter billing and account information into the system with a high level of accuracy and attention to detail
Assist with collection activities, denial follow-up, appeals support, and other related assignments as directed by leadership

What we offer

medical
vision
dental
life and disability insurance
company 401(k) plan

New

Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to join a health...

Location

United States of America , West Chester

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Previous experience in medical billing within a healthcare, physician practice, or related clinical environment
Working knowledge of medical coding principles and insurance claim submission procedures
Experience handling claim follow-up, payment posting support, denials, or medical collections activities
Familiarity with insurance verification processes and payer eligibility review
Strong attention to detail with the ability to identify billing discrepancies and resolve them efficiently
Comfortable working on-site four days per week with a remote workday on Friday
Ability to manage multiple priorities during standard business hours, 8:00 AM to 5:00 PM

Job Responsibility

Review patient billing information for accuracy and submit claims in a timely manner to support consistent reimbursement
Verify insurance coverage and confirm eligibility details before services are processed or billed
Investigate claim issues, resolve denials, and follow up on unpaid balances with payers as needed
Apply medical billing and coding knowledge to ensure charges are entered correctly and aligned with documentation
Manage collection-related activities by tracking outstanding accounts and communicating with appropriate parties to secure payment
Use ePaces and related billing systems to maintain records, monitor claim status, and update account details
Assist with billing workflow adjustments and system-related process updates when required by the department
Collaborate with internal staff to address discrepancies, improve claim outcomes, and keep account information current

What we offer

Medical
Vision
Dental
Life and disability insurance
401(k) plan

Fulltime

Select Country

Medical Denials Specialist

Job Description

Job Responsibility

Requirements

What we offer

Looking for more opportunities?

Medical Denials Specialist

Medical Denials Specialist

Medical Denials Specialist

Medical Denials Specialist

Claims and Denials Specialist

Medical Collections Specialist

Medical Billing Specialist

Medical Biller/Collections Specialist

Medical Billing Specialist

Our AI answers in your language