Denial Specialist

Logan Health

1d • Remote

About The Position

At Logan Health, we're more than just a healthcare provider – we’re a community. Nestled in the heart of Montana, we are committed to delivering exceptional care to our patients while fostering a supportive and collaborative work environment for our team. As a member of Logan Health, you'll be part of a dynamic team that values compassion, innovation, and excellence. We offer opportunities for growth, comprehensive benefits, and a chance to make a meaningful impact in the lives of those we serve. Come join us and experience the Logan Health difference, where your passion meets purpose in a place, you’ll be proud to call home. To work remotely for Logan Health, you must reside in one of the states below: • Arizona • Arkansas • Colorado • Florida • Hawaii • Idaho • Illinois • Indiana • Kansas • Michigan • Minnesota • Missouri • Montana • North Carolina • Ohio • South Dakota • Tennessee • Texas • Virginia • Washington Our Mission: Quality, compassionate care for all. Our Vision: Reimagine health care through connection, service and innovation. Our Core Values: Be Kind | Trust and Be Trusted | Work Together | Strive for Excellence. Join Our Patient Accounting Team at Logan Health! Location: Remote (see approved states list below) Schedule: Day Shift – 8 Hours | Full-Time – 40 Hours Logan Health is seeking a detail-oriented and proactive Denial Specialist to join our Patient Accounting team. This critical role focuses on identifying and resolving insurance claim denials to secure accurate reimbursement and reduce financial loss. If you have strong problem-solving skills, a working knowledge of medical billing, and a passion for improving healthcare outcomes, we want to hear from you!

Requirements

• 5+ years of experience in a hospital or medical office setting, preferably in billing, collections, or insurance follow-up.
• Skilled with basic accounting principles and ten-key by touch.
• Proficient in Microsoft Office Suite – especially Excel – and can quickly learn new systems.
• Strong critical thinking, organizational, and communication skills.
• Thrive working both independently and collaboratively in a fast-paced environment.
• Understand and adhere to HIPAA and confidentiality guidelines.
• Minimum of one (1) year experience in a hospital or medical office setting preferred.
• Proficient with basic accounting and ten-key by touch preferred.
• Prior experience with business mathematical tasks and correspondence preferred.
• Excellent interpersonal and customer service skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
• Possess and maintain computer skills to include working knowledge of Word, Outlook, Excel, and ability to learn other software as needed.
• Proficiency in Excel preferred.
• Possess ability to maintain confidentiality and understand HIPAA guidelines and other applicable federal laws.
• Excellent organizational skills, detail-oriented, a self-starter, possess critical thinking skills and be able to set priorities and function as part of a team as well as independently.
• Commitment to working in a team environment and maintaining confidentiality as needed.
• Excellent verbal and written communication skills including the ability to communicate effectively with various audiences.
• Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
• Possess and maintain computer skills to include working knowledge of Microsoft Office Suite and ability to learn other software as needed.

Nice To Haves

• Experience in denials management, insurance claims processing, or appeal writing.
• Familiarity with CPT, ICD-10, and HCPCS coding.
• Ability to work efficiently within payer portals and understand payer-specific submission requirements.

Responsibilities

• Analyze and resolve denied insurance claims to ensure timely and accurate reimbursement.
• Submit retro-authorization appeals and required documentation in accordance with payer guidelines.
• Research Explanation of Benefits (EOBs) and payer communications to determine denial causes and next steps.
• Coordinate the submission of medical records, appeal letters, and supporting documentation via payer portals, fax, or mail.
• Identify trends in denials and escalate systemic issues to leadership for resolution.
• Collaborate with internal teams to update patient account information and resubmit claims when necessary.
• Maintain accurate and thorough documentation of all appeal actions in internal systems.
• Communicate professionally and promptly with payers, internal departments, and other stakeholders.
• Analyzes and interprets account data to facilitate timely claim and payment resolution as applicable to assigned area(s).
• Collaborates and/or refers unresolved issues and escalates to appropriate party.
• Posts payments and adjustments utilizing the appropriate fee schedule, policy and/or procedures in accordance with patient statements, remittance advices, insurance carriers, electronic downloads, etc. and as applicable to assigned area(s).
• Identifies credits, variances and trends. Performs appropriate action to facilitate resolution in a timely manner.
• Documents all communication, both written and verbal, in an accurate, clear and factual manner.
• Completes account maintenance review to ensure account information is accurate within billing system.
• Acts as a Patient Accounting liaison between patients, clients, providers, payers, vendors and other Logan Health departments as applicable to assigned area(s).
• Interprets explanation of benefits (EOB) message codes, validates payer processing and identifies potential payment discrepancies as applicable to assigned area(s).
• Effectively manages assigned work in accordance with team expectations, department productivity, and quality standards and as applicable to assigned area(s).
• Provides exceptional customer service to stakeholders for questions and concerns.
• Responsible for all Medicare, Medicaid, and Case Management insurance denials processing as applicable to assigned area(s).
• Responsible for all insurance appeals and works with appropriate stakeholders to ensure completion as applicable to assigned area(s).
• Serves as point of contact for quotes, equipment authorization, etc. as applicable to assigned area(s).
• Maintains regular and consistent attendance as scheduled by department leadership.

Benefits

• Collaborative and mission-driven team culture.
• Opportunity to make a direct impact on our revenue cycle and patient care experience.
• Flexible scheduling options, such as 4x10s, are available for the right candidate.
• This position offers full-time remote work.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed