AR Recovery/Healthcare Denials Specialist (On-site Plano, TX)

FinThrive•Plano, TX

49d•Onsite

About The Position

Are you an expert in healthcare insurance reimbursement? Do you thrive on solving complex insurance denials and underpayments? Join our team and play a vital role in ensuring hospitals receive the reimbursements they deserve. We’re looking for an experienced Healthcare Denials Specialist to analyze and resolve payer denials and underpayments. You'll be part of a dynamic team using cutting-edge ARO software to streamline medical claims and collections. As a Denials Specialist II, you will also have the opportunity to mentor junior representatives.

Requirements

3+ years of proven success with healthcare insurance billing, follow-up, reimbursement and collections in a hospital or BPO vendor environment
Deep knowledge of payer rules, including how to interpret denial reasons and submit appeals
Experience with healthcare billing/EHR systems (EPIC, Paragon, Zirmed, or similar)
Strong understanding of medical terminology including claim types (UB-04), CPT, ICD, DRG codes, and EOB/RA
Ability to identify and resolve complex denials and underpayment issues
Excellent communication skills both written and verbal
Strong problem-solving and analytical skills to assess insurance payment discrepancies
Proficiency in Microsoft Excel and Word

Nice To Haves

Medicaid, Medicare, and Commercial billing experience
Associate or Bachelor’s degree

Responsibilities

Investigate and resolve insurance denials and underpayments
Call healthcare insurance companies, affiliates, and providers to resolve underpayment or denial issues
Analyze contracts, billing, and collections to ensure accurate reimbursement
Work closely with leadership and team members to identify denial trends and process improvements
Create appeals, patient correspondences, and payer communication to support claim resolutions
Maintain HIPAA compliance and accurately document all work performed