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Denials Jobs in Georgia (NOW HIRING)

Deloitte

Epic Denials Management Operator

Atlanta, GA · On-site

$17.25 - $23/hr

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Deloitte

Epic Denials Management Operator

Atlanta, GA · On-site

$17.25 - $23/hr

Work you'll do As an Epic Denials Management Operator on the AI & Engineering team, you will be responsible for supporting review denials (835/277 processing) received from third party payers.

Deloitte

Epic Denials Management Operator

Atlanta, GA · Remote

$17.25 - $23/hr

Work you'll do As an Epic Denials Management Operator on the AI & Engineering team, you will be responsible for supporting review denials (835/277 processing) received from third party payers.

Aspirion

Senior Director, Denials

Columbus, GA · On-site

From challenging denials and zero balance reviews to aged accounts receivable, motor vehicle accident claims, workers' compensation, Veterans Affairs, and out of state Medicaid, we take on the work ...

Aspirion

Senior Director, Denials

Columbus, GA · On-site

From challenging denials and zero balance reviews to aged accounts receivable, motor vehicle accident claims, workers' compensation, Veterans Affairs, and out of state Medicaid, we take on the work ...

Aspirion

Senior Director, Denials

Columbus, GA · On-site

From challenging denials and zero balance reviews to aged accounts receivable, motor vehicle accident claims, workers' compensation, Veterans Affairs, and out of state Medicaid, we take on the work ...

Phoebe Putney Health System

Denials Coordinator

Albany, GA · On-site

$16 - $21.25/hr

In lieu of an Associate's Degree, a High School Diploma, and a minimum of 8 years of experience in the Revenue Cycle with experience with analytics and denials. (Required) EXPERIENCE REQUIREMENTS ...

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Denials information

What is the difference between Denials vs Claims Adjuster?

AspectDenialsClaims Adjuster
Primary RoleReview and process claims that have been denied or rejectedEvaluate and settle insurance claims, including approved and denied claims
Work EnvironmentInsurance companies, healthcare providers, or third-party administratorsInsurance companies, public agencies, or independent firms
Required CredentialsKnowledge of insurance policies, coding, and claims processing; certifications varyAdjuster licenses, insurance knowledge, and sometimes certifications

In summary, Denials specialists focus on identifying and managing denied claims, while Claims Adjusters handle the entire claims process, including approved and denied cases. Both roles require insurance knowledge, but their primary functions differ in scope and responsibility.

What are denials in healthcare billing?

Denials in healthcare billing refer to claims that have been submitted to an insurance company but are rejected or not paid. Denials can occur for various reasons, such as missing information, incorrect coding, or eligibility issues. Handling denials is an essential part of the revenue cycle in healthcare organizations, as it ensures providers receive proper reimbursement for their services. Effective denial management involves identifying the cause, correcting errors, and resubmitting claims to maximize revenue.

What are the typical challenges faced in a denials specialist role, and how can they be managed effectively?

A Denials Specialist often encounters challenges such as high volumes of denied insurance claims, navigating complex payer requirements, and communicating effectively with both insurance companies and internal teams. Managing these challenges requires strong attention to detail, persistence in follow-up, and up-to-date knowledge of billing codes and payer policies. Building strong relationships with payers and collaborating closely with billing and coding teams can help resolve denials efficiently and prevent future occurrences, making teamwork and proactive problem-solving critical skills in this role.

What are the key skills and qualifications needed to thrive as a denials specialist?

To thrive as a Denials Specialist, you need a thorough understanding of medical billing, insurance policies, and claims adjudication, often supported by a background in healthcare administration or a related field. Familiarity with practice management software, electronic health records (EHRs), and coding systems such as ICD-10 and CPT is typically required. Strong analytical skills, attention to detail, and effective communication help you resolve complex denials and collaborate with providers and payers. These competencies are vital for maximizing reimbursement, reducing claim rejections, and ensuring the financial health of healthcare organizations.
What are the most commonly searched types of Denials jobs in Georgia? The most popular types of Denials jobs in Georgia are:
Denials jobs near you

Denials and Eligibility Specialist

St. Joseph's/Candler

Savannah, GA • On-site

$19.28/hr

Full-time

Posted 8 days ago

St. Joseph's/Candler Health System rating

7.0

Company rating: 7.0 out of 10

Based on 20 frontline employees who took The Breakroom Quiz

Job description

  • Position Summary
    • Revenue Cycle Denials and Eligibility Specialist will be responsible for daily QA, eligibility, frontend rejections, denial auditing, and immediate correction of all registered accounts to ensure accurate billing and reimbursement. The scope of work will encompass all Government, Commercial, and Managed Care payers, and include all service lines and all denial types. Position will be a liaison with other departments, physicians and other clinicians within and outside the organization in order to facilitate timely and accurate submission. This position will work closely with management, precertification, insurance verification, and operations to ensure trends are identified and corrected to reduce denials. Revenue Cycle Denials and Eligibility Specialist will also be involved with education and training based on identified trends and audit results.
  • Education
    • None Required
  • Experience
    • 2-3 years hospital revenue cycle experience
    • 1-2 Years insurance experience
    • Previous Team Lead or Supervisor Experience - Preferred
  • License & Certification
    • None Required
  • Core Job Functions
    • Directly works to resolve all eligibility denials in billing system and from payer remits within 1 business day. Directly resolves all RQA errors within 1 business day.
    • Completes monthly Root Cause Analysis on denials and eligibility to determine trends and using the results to keep leadership informed and provide continuing education and improvement.
    • Reviews monthly denials with leadership teams of the physician's office, ancillary departments and revenue cycle. Identifies improvement opportunities, educational needs and reduction of denials opportunities.
    • Escalates eligibility and payer denial trends or underpayments to appropriate internal leadership for quick resolution.

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