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Denials Jobs in Georgia (NOW HIRING)

Insight Global

AR Follow Up

Atlanta, GA · On-site

$21/hr

M-F 6:30-9am EST start time, during training they follow schedule of who is training them (7ish) Must Haves: 2+ years of Hospital Billing Denials Experience (DENIALS AND CLAIMS)!!!!! Epic Experience ...

St. Joseph's/Candler

Insurance Collector

Savannah, GA · On-site

$17.09/hr

Resolves payer denials promptly and appropriately. Updates account Insurance demographic information accordingly. Rebills accounts when necessary and documents all action taken. * Acts upon computer ...

St. Joseph's/Candler

Insurance Collector

Savannah, GA · On-site

$17.09/hr

Resolves payer denials promptly and appropriately. Updates account Insurance demographic information accordingly. Rebills accounts when necessary and documents all action taken. * Acts upon computer ...

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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

AR Follow Up

Insight Global

Atlanta, GA • On-site

$21/hr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 23 days ago

Job description

Client: Orlando Health

Location: REMOTE

Duration: 6 month c2h

PR: 21

Hours: M-F 6:30-9am EST start time, during training they follow schedule of who is training them (7ish)

Must Haves:

2+ years of Hospital Billing Denials  Experience (DENIALS AND CLAIMS)!!!!!!!

Epic Experience

HS Diploma

---------BCBS payor

Plus:

Professional Claims billing

Day to Day

The Hospital Billing Specialist is responsible for accurately processing hospital claims, managing patient accounts, and updating insurance information within Epic. This role requires strong hospital billing experience, comfort working in Epic throughout the day, and the ability to collaborate with a remote or hybrid team through scheduled meetings and office hours.

Key Responsibilities

  • Process and work hospital billing claims within Epic
  • Review, manage, and resolve patient accounts and billing issues
  • Update and verify insurance information accurately in Epic
  • Ensure claims are billed correctly and follow payer requirements
  • Communicate with team members via team chat to ask questions and resolve issues
  • Participate in biweekly team meetings (camera on)
  • Attend weekly office hours to ask questions and receive guidance
  • Maintain compliance with hospital billing policies and procedures

Day-to-Day Activities

  • Work in Epic for the majority of the workday
  • Complete mandatory Epic training (2 days) and successfully pass certification
  • Participate in an additional 2 weeks of role-specific training after Epic training
  • Collaborate closely with the billing team using chat, calls, and virtual meetings
  • Actively manage claims and accounts while ensuring insurance data accuracy