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Insurance Denial Jobs in Riverside, IA (NOW HIRING)

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Insurance Denial information

See Riverside, IA salary details

$26.6K

$59.2K

$99.8K

How much do insurance denial jobs pay per year?

As of Jun 1, 2026, the average yearly pay for insurance denial in Riverside, IA is $59,182.00, according to ZipRecruiter salary data. Most workers in this role earn between $41,800.00 and $79,300.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an Insurance Denial Specialist, and why are they important?

To thrive as an Insurance Denial Specialist, you need a solid understanding of medical billing, insurance policies, and claims processing, often supported by experience in healthcare administration or a related certification. Familiarity with billing software, electronic health records (EHRs), and denial management systems is typically required. Strong analytical thinking, attention to detail, and effective communication skills help in resolving claim issues and collaborating with both patients and insurance providers. These skills are crucial for efficiently overturning denials, optimizing reimbursements, and ensuring financial stability for healthcare organizations.

What are some common challenges faced by professionals working in insurance denial roles and how can they be addressed?

Professionals in insurance denial roles often encounter challenges such as navigating complex insurance policies, handling high volumes of denied claims, and communicating with both patients and insurance providers to resolve issues. Staying updated on payer guidelines and developing strong organizational skills are essential to efficiently manage appeals and minimize errors. Collaboration with billing and clinical teams can help identify patterns in denials and implement process improvements, ultimately leading to higher claim approval rates and smoother workflows.

What is insurance denial?

Insurance denial occurs when an insurance company refuses to pay for a healthcare service, treatment, or medication that was submitted in a claim. This can happen for various reasons, such as missing information, services not being covered under the policy, or lack of pre-authorization. Understanding the reason for the denial is important, as patients or providers can often appeal the decision if they believe it was made in error. Handling insurance denials is a critical part of medical billing and revenue cycle management.

What is the difference between Insurance Denial vs Insurance Claims Specialist?

AspectInsurance DenialInsurance Claims Specialist
Primary RoleHandling and resolving denied insurance claimsProcessing, reviewing, and submitting insurance claims
Required CredentialsKnowledge of insurance policies, denial reasonsUnderstanding of claims procedures, certifications vary
Work EnvironmentHealthcare providers, insurance companies, legal settingsHospitals, clinics, insurance companies
Industry UsageFocuses on appeals and resolution of denialsFocuses on claim submission and processing

Insurance Denial specialists focus on addressing and resolving claims that have been denied, often involving appeals and detailed review. Insurance Claims Specialists handle the entire claims process, from submission to follow-up. While both roles require knowledge of insurance policies, their primary functions differ: one resolves denials, the other manages claims from start to finish.

Insurance Denial jobs near you
Residential Admissions and Authorization Specialist

Residential Admissions and Authorization Specialist

Community and Family Resources

Iowa City, IA • On-site

$16.25 - $22.50/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 12 days ago

Job description

Community and Family Resources is committed to supporting clients at every stage of their recovery journey. For many individuals, the first step begins with entering a residential treatment program. Our Residential Admissions and Authorization Specialist plays a vital role in this process by guiding clients through admissions and ensuring a smooth, welcoming transition into our facility.
We are currently seeking a Residential Admissions and Authorization Specialist to work with our residential programs in both Des Moines and Iowa City. The person in this role can be located in either area.
Essential Duties and Responsibilities:
  • Communicate with referring agency to determine if a potential client meets necessary requirements for residential.
  • Conduct initial interviews and explain the treatment process with clients and referral sources.
  • Staff referrals with the appropriate Residential Program Supervisor, clinical department, and medical department prior to scheduling admission appointment.
  • Prepare client for admission by conducting a preadmission phone and/or in-person contact with client.
  • Review client records and insurance benefits to determine need for prior authorization.
  • Prepare and submit accurate prior authorization requests to insurance companies, including detailed medical documentation to support the need for the service.
  • Facilitate new client orientation including providing a copy of the client handbook and tour of facility with the admissions Treatment Specialist from the identified unit in which the client will be placed.
  • Track authorization requests and follow up with insurance companies as needed to check on status of pending authorizations.
  • Review denial notifications, identify reason for denial, and work with providers to appeal or resubmit authorization requests with additional supporting documentation.
  • Completion of the PHQ9, DG SBIRT Screening and coordinating care with the appropriate department.
  • Provide clients/families with referral sources for services unavailable within the agency or when agency services are inappropriate.
  • Participate in intra-agency staffing to determine needed services and appropriate modes of treatment.
  • Assist clients in completion of necessary assessment forms/documents and appropriate releases.
  • Prepare and distribute assessment results, reports, etc. as required and requested.

Schedule:
  • Type: Full-Time
  • Hours: Monday-Friday, 9a-5p

Education and Experience Qualifications:
  • A minimum of associate's degree is required.
  • A minimum of 2 years of experience in substance use treatment or related field is required.
  • Experience with insurance billing or prior authorizations is strongly preferred.
  • Experience working with persons experiencing co-occurring symptoms is preferred.
  • Current certification as a Certified Alcohol and Drug Counselor (tCADC, CADC, or IADC) through the Iowa Board of Certification is preferred.

Benefits:
  • Health insurance
  • Dental insurance
  • Vision insurance
  • IPERS retirement benefit
  • Optional 401K
  • Employee Assistance Program
  • Generous PTO (20 days accrued in your first year)
  • 9 paid holidays
  • Paid trainings and CEU opportunities
  • Public Student Loan Forgiveness employer
  • Tuition reimbursement
  • Various discounts including tuition fees at partner schools, travel, cell phone plans, and more!

Application Process: Candidates interested in applying should submit an application and resume. Candidates will be required to complete a background check, drug screen, and TB test prior to starting employment.
Equal Opportunity Employer: Community and Family Resources is an Equal Opportunity Employer, including Veterans and Individuals with Disabilities.

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