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Denials Jobs in Georgia (NOW HIRING)

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Denials information

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 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 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 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 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 Specialist - FT

Phoebe Putney Health System

Albany, GA • On-site

$16.50 - $22/hr

Full-time

Posted 8 days ago

Job description

Job Number:

34659

Location:

Phoebe North Campus

Street Address:

2000 Palmyra Rd

City, State:

Albany, Georgia

Zip Code:

31701

Department:

PPMH PATIENT ACCOUNTING

Shift:

First Shift

Job Type:

Full time

Posted Date:

2026-08-25

Job Description Summary:

JOB SUMMARY
Processes and monitors follow up on denial accounts including disputes, appeals and grievances with insurance payors, governmental payors and state agencies. All activities will be performed in support of the strategy, vision and values of Phoebe. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. All activities must be in compliance with Equal Employment Opportunity laws. HIPAA, ERISA and other regulations, as appropriate.

Description:

EDUCATION REQUIREMENTS

2 year / Associate Degree in Business Administration or closely related field, in lieu of an Associates Degree a minimum of 5 years experience in Revenue Cycle with experience in patient accounting.


EXPERIENCE REQUIREMENTS

2 - 3 years in Patient accounting functions of the revenue cycle (Required)

5+ years Revenue Cycle Experience with concentration in Patient Accounting to include billing, follow up, denials and denial recovery (Preferred)


CERTIFICATIONS AND LICENSURES

Required Certifications/Licensures: CPAR Certification must be obtained within 20 months of hire

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