Medical Denials Specialist Job at Robert Half (Carmel)

Senior Training Specialist – Operations (Medical Coding)

We are seeking a highly skilled Senior Training Specialist in Medical Coding to ...

Location

India , Chennai

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Strong interpersonal and communication skills
Excellent ability to teach and coach people
Working knowledge of MS Office
Good knowledge of US healthcare RCM
Minimum 5 years of work experience with expertise in multispecialty Denial coding and EM coding
Minimum of 3 to 4 years in Medical coding is preferred
Must possess 1 year of work experience in denial coding management and 1 year of work experience in a Trainer role
AHIMA or AAPC Certification is mandatory

Job Responsibility

Follow the training agenda and facilitate the training for Coding – Denial Management
Accurately code medical records using ICD-10-CM, CPT conventions & HCPCS codes
Able to browse payer guidelines and collate the most accurate information with payer specifics
Interpret medical records of the patients in different specialities and provide appropriate denial actions for the analysis done
Handle diverse groups of new hires and existing coder groups
Provide continuous education for a given set of Clients
Accommodate changes on short notice with business requirements
Train and mentor coders for developing capability on denial management in the organization
Work with transition clients and provide SME support
Participate in focus and compliance audits internally for all types of coders and auditors (ATA)

Medical Reimbursement Specialist

We are in search of a Medical Reimbursement Specialist to join our team. Station...

Location

United States , Princeton

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 3 years of experience in a similar role
Proficient in benefit functions
Demonstrated expertise in billing functions
Experience in claim administration
Familiarity with collection processes
Ability to handle and resolve medical denials
Comprehensive knowledge of Medicare

Job Responsibility

Analyze and categorize outstanding claims based on payer, denial reason, and claim value
Investigate and take corrective action on unpaid, denied, or underpaid claims
Collaborate with internal teams to obtain missing documentation and expedite claim resubmission
Evaluate common denial reasons and address them accordingly, such as coding errors, medical necessity, and prior authorization
Submit corrected claims and formal appeals as required
Communicate with insurance payers to resolve aged claims and escalate unresolved claims as necessary
Maintain comprehensive records of all payer interactions
Identify the root causes of denials and implement best practices to prevent future issues
Suggest changes to workflow to enhance claim submission accuracy and speed
Conduct training for in-house billing teams on claim recovery strategies

What we offer

medical, vision, dental, and life and disability insurance
eligibility to enroll in company 401(k) plan

Fulltime

Medical Billing Specialist

Location

United States , Dothan

Salary:

Not provided

RealTime (AL)

Expiration Date

Until further notice

Requirements

Medical Billing Experience
Perform posting charges
Perform completion of claims to payers
Conduct duties in a professional and timely fashion
Submit billing data to the appropriate insurance providers
Process claims
Resolve denial instances
Perform claim follow-up
Achieve maximum reimbursement for services provided
Deploy, maintain and report on various programs

Job Responsibility

Medical billers play a vital role in the connection between health care providers, patients, and insurance companies. At RealTime, we provide excellent Revenue Cycle Management to medical practices across the Southeast and through the Midwest.

What we offer

Training
Competitive pay
Phone allowance
Generous PTO
401(k) with company match
Health & Wellness Benefits including medical, dental, and vision
Company-sponsored events for fun and fellowship

Fulltime

Medical Billing Specialist

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

Location

United States , King of Prussia

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 1 year of experience in medical billing, claims, or collections
Proficiency in accounting software systems and electronic health record (EHR) systems
Familiarity with Medicaid processes and commercial insurance claims
Strong understanding of accounts receivable, denial management, and appeals
Experience working with billing and authorization functions
Ability to accurately input and manage billing data
Excellent communication skills to collaborate with team members and external payors
Knowledge of compliance policies related to medical billing and collections

Job Responsibility

Process and submit primary and secondary claims for both commercial insurance and Medicaid
Investigate and resolve claim denials, performing appeals as necessary to ensure proper reimbursement
Manage accounts receivable by following up on claims through resolution, including correcting billing errors and addressing rejections
Input and review billing data for accuracy, ensuring compliance with company policies and procedures
Collaborate with the Billing Manager and clinic teams to ensure accurate and timely billing
Track and verify Medicaid status for clients while maintaining relationships with payors to facilitate successful claims processing
Assist intake teams with Medicaid documentation for new clients and those requiring reassessment
Utilize various insurance portals and systems, including Waystar, to handle denial responses and claims follow-ups
Ensure adherence to compliance standards in all billing and collections activities
Perform other tasks as assigned by the Billing Manager or Director

What we offer

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

Fulltime

Medical Billing Specialist

We are seeking a dedicated and detail-oriented Medical Billing Specialist to joi...

Location

United States , Hagerstown

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Associate’s degree in Health Information Technology, Business Administration, or a related field is preferred
1+ years of experience in medical billing and accounts receivable, preferably within a healthcare setting
Strong knowledge of medical terminology, coding systems (CPT, ICD-10, HCPCS), and insurance regulations
Experience with medical billing software and electronic health records (EHR) systems
Excellent communication skills, both verbal and written
Detail-oriented with strong organizational and analytical skills
Ability to manage multiple priorities and meet deadlines in a fast-paced environment
Knowledge of HIPAA regulations and confidentiality requirements

Job Responsibility

Billing & Coding: Accurately review and submit medical claims to insurance companies, government programs (e.g., Medicare, Medicaid), and patients based on services provided
Accounts Receivable Management: Monitor and follow up on unpaid claims and accounts, ensuring timely resolution and payment collection
Claim Denial Management: Investigate and resolve denied or rejected claims, working with insurance providers to rectify issues and ensure proper reimbursement
Payment Posting: Post payments, adjustments, and denials to patient accounts accurately
Patient Communication: Communicate with patients and insurance companies to resolve billing inquiries, provide payment information, and answer any questions related to their accounts
Account Reconciliation: Ensure all accounts are reconciled and balanced, identifying discrepancies and making necessary adjustments
Compliance: Maintain up-to-date knowledge of relevant billing codes, insurance policies, and regulations to ensure compliance with industry standards and government regulations
Reporting: Generate and review accounts receivable reports, aging reports, and other billing data to ensure financial goals are met and identify areas for improvement
Collaboration: Work closely with the clinical and administrative teams to resolve any billing issues, discrepancies, or concerns

What we offer

Medical, vision, dental, and life and disability insurance
Company 401(k) plan
Access to top jobs
Competitive compensation

Fulltime

Medical Accounts Receivable Specialist

This role is within the healthcare industry, where you will be crucial in assist...

Location

United States , Jeffersontown, Kentucky

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proficient in Accounting Software Systems
Experience with ADP - Financial Services
Familiarity with CRM
Proficiency in Epic Software
Knowledge of ERP - Enterprise Resource Planning
Ability to handle Accounting Functions
Experience with Accounts Receivable (AR)
Proficient in Billing Functions
Capable of managing Cash Activity
Experience in Cash Handling

Job Responsibility

Oversee the processing of appeals by collecting necessary information and resubmitting claims
Manage the initiation of collection follow-ups for unpaid or rejected claims with the relevant Payer
Maintain a robust and positive relationship with team members and Payer representatives
Handle communication of payment or denial trending issues that impact revenue, to leadership
Take responsibility for reviewing unpaid claims and investigating reasons for payment delays
Handle the resolution of claim partial payments and denials with Payers
Engage insurance companies and attorneys to resolve any discrepancies and ascertain the status of bills to secure proper reimbursement
Review outstanding accounts receivables for assigned Payers and maintain the aging report
Ensure any necessary adjustments in accounts are processed accurately and promptly
Keep accurate customer credit records and process customer credit applications efficiently

What we offer

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

Fulltime

Billing Specialist

Location

United States

Salary:

Not provided

Pafford EMS

Expiration Date

Until further notice

Requirements

Proficient with a PC
Knowledge of Health Insurance Portability and Accountability Act (HIPAA)
Knowledge of procedure and diagnostic codes (HCPCS and ICD-10 codes)
Knowledge of medical terminology
Knowledge of Medical Billing
Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and commercial payers
Customer service skills for interacting with patients regarding medical claims and payments
Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections
Ability to work independently and with a group
Working knowledge of MS Word, Excel

Job Responsibility

Obtain referrals and pre/post-authorizations for ambulance services
Check eligibility and benefits verification
Review insurance and facility claims for accuracy and completeness
Prepare, review, and transmit claims using billing software, clearinghouse, and payer websites
Following up on unpaid claims within standard billing cycle timeframe
Reviewing underpaid claims for appropriate escalation steps to ensure appropriate reimbursement for services
Calling insurance companies regarding any payment discrepancies
Identifying and billing secondary or tertiary insurance
Processing incoming mail and taking appropriate follow up actions to resolve accounts
Researching and appealing denied claims

Medicaid Billing Specialist

Pafford Medical Services is seeking a detail-oriented and experienced Medicaid B...

Location

United States

Salary:

Not provided

Pafford EMS

Expiration Date

Until further notice

Requirements

Minimum of 2-3 years of experience in medical billing, with a focus on Medicaid billing and follow-up
In-depth knowledge of Medicaid regulations, coding (ICD-10, CPT), and billing procedures
Experience with medical billing software and electronic health records (EHR) systems
Strong analytical and problem-solving abilities
Excellent attention to detail and accuracy
Effective communication and interpersonal skills
Ability to work independently and manage multiple tasks
Proficiency in Microsoft Office Suite (Word, Excel)
High School Diploma or GED
Minimum of 2-3 years revenue cycle management experience

Job Responsibility

Accurately prepare and submit Medicaid claims for services rendered by Pafford EMS
Ensure all claims are coded correctly and comply with Medicaid regulations and guidelines
Monitor and verify patient eligibility and insurance coverage
Conduct follow-up on outstanding claims and ensure timely resolution of billing issues
Communicate with Medicaid offices, patients, and other relevant parties to resolve claim discrepancies, denials, or rejections
Review and appeal denied claims, providing necessary documentation and information
Maintain accurate and up-to-date records of billing activities, payments, and follow-ups
Generate regular reports on billing status, outstanding claims, and payment trends
Stay informed about changes in Medicaid regulations and billing procedures
Participate in training and development opportunities to enhance knowledge and skills

Fulltime

Medical Denials Specialist

Robert Half

Location:
United States , Carmel

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
May 05, 2026

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