Denials Specialist Healthcare

Denials Specialist Healthcare Job Description

Professionals in this role must have knowledge of ICD-10, CPT coding, medical terminology and Microsoft Office. Organizations seek those with strong problem-solving skills, the ability to work well under pressure, and the ability to communicate professionally, effectively and courteously with all types of constituencies. Three to five years of experience in healthcare billing or collections and a high school diploma or the equivalent is required, though most organizations prefer candidates with some college coursework completed.

Typical denials specialist duties:

Validating reasons for denying healthcare claims and ensuring that coding is accurate

Coordinating consultations or account referrals when necessary

Researching and compiling necessary supporting documentation for appeals

Generating appeals and online reconsiderations as needed

Escalating exhausted appeals efforts for resolution

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Salary for Denials Specialist Healthcare

37250 - 50250

25th percentile

37250

The candidate is new to the role and building the needed skills, experience and autonomy.

50th percentile

43000

The candidate has the experience to perform core responsibilities without direct supervision and is comfortable with the role’s processes and subject matter.

75th percentile

50250

The candidate delivers value beyond the stated job duties, has advanced qualifications and experience, and is ready for the next career level.

Projected salaries for related positions

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25th percentile

50th percentile

75th percentile

Revenue Cycle Director – Healthcare

84500

109750

130250