What are the responsibilities and job description for the Healthcare Claims Denials Specialist position at Internal Medicine Group?
Job Title: Healthcare Claims Denials Specialist
Location: On-site 1801 NE 123 Street Suite 405, North Miami Fl 33181
Job Summary:
We are seeking a detail-oriented Healthcare Claims Denials Specialist to review, correct, appeal, and resubmit denied healthcare claims. The ideal candidate will have strong knowledge of medical billing, payer guidelines, and denial management processes, with a focus on maximizing reimbursement and reducing future denials.
Key Responsibilities:
- Review denied medical claims to identify root causes and determine corrective actions
- Correct coding, billing, and documentation errors in compliance with payer and regulatory guidelines
- Prepare, submit, and track appeals for denied claims within payer timelines
- Resubmit corrected claims and follow up with insurance carriers as needed
- Analyze denial trends and provide recommendations to reduce recurring denials
- Maintain accurate documentation of appeal outcomes and claim status
- Communicate effectively with internal teams, providers, and payers regarding claim issues
- Stay current on payer policies, billing regulations, and industry best practices
Qualifications:
- High school diploma or equivalent required; associate or bachelor’s degree preferred
- 3 years of experience in medical billing, coding, or denial management
- Strong knowledge of insurance claim processes, EOBs, and payer requirements
- Familiarity with CPT, ICD-10, and HCPCS coding
- Experience with claim appeals and resubmissions
- Proficiency with billing software and electronic health record (EHR) systems
- Strong analytical, organizational, and problem-solving skills
How to Apply: Please submit your resume to nayubi@pgsfl.net
Job Type: Full-time
Pay: From $19.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience:
- ICD-10: 1 year (Preferred)
Ability to Commute:
- North Miami, FL 33181 (Required)
Work Location: In person
Salary : $19