Denials & Appeals Specialist

Location - Mesquite

Join our team!

Are you looking for an opportunity to serve a bigger purpose with a growing organization? Are you passionate and dedicated to making a positive impact? Then we have a spot waiting for you. We are seeking an engaging Denial and Appeal Specialist to join our growing team in Mesquite. As part of the HHM team, you would be responsible for reviewing, analyzing, and resolving denied healthcare claims by preparing and submitting appeals to insurance companies. This role ensures proper reimbursement by identifying root causes of denials and working closely with billing, coding, and clinical teams.

Here's a sneak peek at what you'll do:

• Review and analyze denied insurance claims across all payer types (Medicaid, MCO’s, Medicare, Commercial etc.)


• Perform detailed denial analysis to determine root cause (coding, documentation, eligibility, authorization, billing errors, payer issues)


• Prepare and submit accurate and timely appeal requests with supporting documentation


• Own assigned denial inventory and ensure timely resolution


• Follow up with insurance companies on appeal status and resolution 


• Collaborate with providers, coders, and billing teams to gather required information 


• Track and document all appeals, outcomes, and correspondence 


• Identify denial trends and recommend process improvements to reduce future denials 


• Ensure compliance with payer policies, coding standards, and HIPAA regulations


• Develop workflows and improve denial management processes

What you need to succeed

To be a productive member of our team, you will have a pleasant and professional demeanor, be a self-starter, have the ability to work independently, strong communication skills and the ability to preserve confidentiality. You will also have the following:

• High school diploma or equivalent (Associate’s or bachelor's preferred)


• 3-5yearsof related experience, prior experience in a revenue cycle with a community-based setting with focus on denials and appeals

• Experience in medical billing, coding, or revenue cycle management along with experience with Medicaid, Medicare, and commercial payers


• CPC or CPB is a plus


• Knowledge of CPT, ICD-10, and HCPCS coding systems 


• Familiarity with insurance payer policies and claims processes 


• Experience with EMR/EHR and billing software


• Bilingual (English/Spanish) a plus

What We Offer

At HHM Health, the health and well-being of our employees matter just as much as that of our patients. We offer free employee coverage for vision, dental, and life insurance; and competitive medical premiums. Additionally, our full-time employees are eligible for the following:

• Health Savings Account


• 403(b) retirement savings plan with dollar-for-dollar matching up to 3% and match 50% of the next 2% (contribute 5% to get 4% matched). 100% vested upon enrollment.


• Generous paid time off plan for full-time employees (includes Sick and Volunteer Days)


• Paid Holidays


• Accidental Death & Dismemberments (ADD) plan


• Short-term & Long-term Disability


• Employee Assistance Programs (EAP)


• HHM CARES Fund (employee emergency relief fund)

We’re battling the Dallas Community’s Healthcare Crisis

At HHM Health, our mission is to provide quality healthcare to all in the growing DFW Metroplex. Our vision is to be the best patient-focused health center providing holistic care. We exemplify our CARES Values (Compassion, Advocacy, Respect, Excellence, Servant Heart) to provide a positive & meaningful patient experience to all in Dallas and the surrounding counties.

Equal Opportunity Employer

HHM Health is committed to providing equal employment opportunity to all individuals regardless of their race, color, religion, gender identity and expression, age, sexual orientation, national origin, disability, veteran status, marital status or any other characteristic protected by federal, state or local law. HHM Health hires and promotes based solely on the qualifications of the individual and the essential functions of the job being filled.

To learn more about how we’re making a difference, visit us online at: https://www.hhmhealth.org/