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Denial Management Specialist Jobs (NOW HIRING)

Nationwide Credit & Collection Inc.

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Denial Management Specialist

Oak Brook, IL · Remote

$22 - $25/hr (+ commission)

Denial Management Specialist Essential Job Functions · Investigates insurance denials to identify action necessary to resolve the claim- including calls to payor and multiple computer systems, e.g ...

EvergreenHealth

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

Wage Range: $28.83 - $46.14 per hour 5 years of experience in denial management, utilization review or prior authorization in a hospital, provider, or healthcare system. Healthcare medical billing ...

Evergreen Health

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

Wage Range: $28.83 - $46.14 per hour 5 years of experience in denial management, utilization review or prior authorization in a hospital, provider, or healthcare system. Healthcare medical billing ...

EvergreenHealth

Denial Management Specialist

Kirkland, WA · On-site

$28.83 - $46.14/hr

Description Wage Range: $28.83 - $46.14 per hour 5 years of experience in denial management, utilization review or prior authorization in a hospital, provider, or healthcare system. Healthcare ...

Vital Connect Inc

Denial Management Specialist

CA · Remote

Description Purpose The Denial Management Specialist role belongs to the Revenue Cycle team and is responsible for investigating and resolving complex third-party insurance denials and outstanding ...

Vital Connect Inc

CA · On-site

Purpose The Denial Management Specialist role belongs to the Revenue Cycle team and is responsible for investigating and resolving complex third-party insurance denials and outstanding claims. The ...

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How much do denial management specialist jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for denial management specialist in the United States is $23.64, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $27.88 per hour, depending on experience, location, and employer.

What is a denial management specialist?

Denial Management Specialists are healthcare professionals who focus on identifying, analyzing, and resolving insurance claim denials. They work with healthcare providers, payers, and billing teams to investigate the reasons behind denied claims and implement strategies to prevent future denials. Their goal is to maximize revenue recovery for healthcare organizations by ensuring claims are properly processed and reimbursed. Denial Management Specialists must have strong analytical, communication, and problem-solving skills, as well as a solid understanding of insurance policies and healthcare billing procedures.

What does a denial management specialist do?

A denial management specialist typically works for a hospital or health network to review and resolve denied patient insurance claims. Your duties as a denial management specialist are to review all paperwork the insurance company sends about a claim denial. You then form an appeal that includes documentation and an argument and follow up with the insurance company about possible reimbursement. Your responsibilities also include assisting insurance companies with gathering additional paperwork they may need to process a denial appeal from a patient. You keep a detailed record of all communications with patients and insurance companies during the appeals process.

What are the key skills and qualifications needed to thrive as a denial management specialist, and why are they important?

To thrive as a Denial Management Specialist, you need a solid understanding of medical billing, coding, and insurance claims processes, often supported by experience in healthcare administration or a related certification. Familiarity with revenue cycle management software, electronic health records (EHRs), and payer portals is typically required. Strong analytical skills, attention to detail, and effective communication are crucial for investigating denials and collaborating with payers and providers. These competencies ensure accurate claim resolution, minimize revenue loss, and help maintain the financial health of healthcare organizations.

What are some common challenges faced by denial management specialists, and how can they effectively address them?

Denial Management Specialists often encounter challenges such as identifying root causes of claim denials, navigating complex payer requirements, and managing high volumes of denied claims. To address these, specialists need strong analytical skills to interpret denial codes, excellent communication to coordinate with payers and internal teams, and attention to detail to ensure accurate resubmissions. Staying current with insurance guidelines and leveraging denial management software can also help streamline the appeals process and improve overall claim recovery rates.

What is the difference between Denial Management Specialist vs Medical Billing Specialist?

AspectDenial Management SpecialistMedical Billing Specialist
CredentialsCertifications like CPC, CCS, or similarCertifications like CPC, CCS, or similar
Work EnvironmentHealthcare facilities, insurance companies, billing companiesHealthcare providers, hospitals, clinics
Primary FocusIdentifying, appealing, and resolving claim denialsCreating and submitting claims, patient billing, payment posting

Both roles require similar certifications and often work in healthcare settings. However, a Denial Management Specialist primarily focuses on resolving denied claims through appeals, while a Medical Billing Specialist handles the entire billing process, including claim submission and patient invoicing. Understanding these differences helps employers and job seekers target the right position in healthcare revenue cycle management.

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Denial Management Specialist jobs near you
Infographic showing various Denial Management Specialist job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 86% Physical, 2% Hybrid, and 12% Remote job distribution, with an average salary of $49,173 per year, or $23.6 per hour.

Denial Management Specialist

Mile Bluff Medical Center

Mauston, WI • On-site

Full-time

Re-posted 28 days ago

Mile Bluff Medical Center rating

6.7

Company rating: 6.7 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

638th of 1,066 rated hospitals

Job description

General Information:
Job title: Denial Management Specialist
Schedule: Full-time, 80 hours per pay period; Monday-Friday, 8:00am - 4:30pm
Weekend rotation: No weekends
Holiday rotation: Paid Holidays
Position Summary:
The Denial Management Specialist position gathers, interprets, and reviews data to assess for root cause analytics to then implement process improvement to reduce denials and write offs to optimize A/R.
Position Responsibilities:
  • Creates Revenue Cycle reports
  • Responsible for collecting, researching and analyzing business and operational data.
  • Provides monitoring and trending of system denials.
  • Works with other departments, including operational, to reduce the dollar amounts of denials and rework.
  • Works denials to resolution.
  • Collaborates with other revenue cycle departments to educate on denial trends.
  • Identifies and monitors process improvement efforts with the revenue cycle.
  • Establishes definitions and criteria for reporting avoidable denials.
  • Attends workshops and seminars to maintain a high level of knowledge and capabilities related to position.
  • Perform other duties as requested.

Position Requirements:
  • High school diploma or equivalent required.
  • AA or 4 years of equivalent experience required.
  • 5+ years of related work experience preferred.
  • Experience working in the medical industry preferred.
  • Exceptional accuracy and attention to detail required.

Knowledge, Skills, & Abilities
  • Intermediate to Expert proficiency with computers is required.
  • Thorough understanding of billing process.
  • Basic understanding of coding.
  • Strong quantitative and analytical competency.
  • Self-starter with excellent interpersonal communication and problem-solving skills.

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