Denials Specialist

TEKsystems•Atlanta, GA

2d•$22 - $25•Remote

About The Position

We are seeking a highly analytical and detail-oriented Denials Specialist to join our team. This role is responsible for managing and resolving denied claims through in-depth investigation, payer communication, and cross-functional collaboration. Unlike traditional denial roles, this position requires strong critical thinking skills, as claims are processed outside of standard CPT billing and heavily managed through Excel-based workflows. The ideal candidate is proactive, tech-savvy, and skilled in building relationships with payer contacts to drive successful claim resolution.

Requirements

Minimum 6 months to 3 years of denials management experience within a provider-side environment
Proven ability to independently investigate and resolve claim denials end-to-end
Experience using payer portals to review denial reasons, pull reports, and resubmit claims
Strong analytical and critical thinking skills; able to diagnose issues and determine solutions
Advanced proficiency in Excel and/or Google Sheets (sorting, filtering, formulas required; pivot tables and VLOOKUP preferred)
Comfortable working on a Mac operating system with dual monitors
Excellent communication and relationship-building skills, particularly with external payer contacts
Highly organized with the ability to manage multiple priorities

Responsibilities

Review and analyze denied claims by accessing payer and claims portals (e.g., Athena and payer-specific systems)
Identify root causes of denials, including copays, deductibles, coding issues, or service discrepancies
Categorize denied and unpaid claims into appropriate buckets based on denial reason
Collaborate with internal Revenue Cycle Specialists to research, correct, and resolve claim issues
Resubmit corrected claims to payers in a timely and accurate manner
Maintain detailed tracking and reporting of denials using Excel and Google Sheets
Communicate directly with payer representatives to resolve issues and prevent future denials
Continuously identify trends and opportunities to improve denial resolution processes