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Insurance Denial Jobs (NOW HIRING)

Nationwide Credit & Collection Inc.

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Denial Management Specialist

Oak Brook, IL · Remote

$22 - $25/hr

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 ...

Vital Connect Inc

Denial Management Specialist

CA · Remote

Strong understanding of insurance plans (HMO, PPO, IPO, etc.), coordination of benefits, medical terminology, limited coverage and utilization guidelines, denial remark codes and timely filing ...

The US Oncology Network

Insurance Specialist

Eugene, OR · On-site

$21 - $34/hr

A person who is comfortable on the phone, has experience and knowledge of insurance companies, EOBs, managing insurance denial processes, and medical terminology will find success in this role.

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 ... Medical, vision and dental insurance * On-demand virtual health care * Health Savings Account

EvergreenHealth

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

Analyzes denial trends, develops appeal strategies, collaborates with clinical and operational ... Medical, vision and dental insurance On-demand virtual health care Health Savings Account Flexible ...

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Insurance Denial information

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$28K

$62.3K

$105K

How much do insurance denial jobs pay per year?

As of Jun 3, 2026, the average yearly pay for insurance denial in the United States is $62,283.00, according to ZipRecruiter salary data. Most workers in this role earn between $44,000.00 and $83,500.00 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.

What cities are hiring for Insurance Denial jobs? Cities with the most Insurance Denial job openings:
What states have the most Insurance Denial jobs? States with the most job openings for Insurance Denial jobs include:
Insurance Denial jobs near you

Reimbursement Specialist

University Health - San Antonio

San Antonio, TX • On-site

$16.50 - $23/hr

Full-time

Posted 3 days ago

Job description

POSITION SUMMARY/RESPONSIBILITIES
Identifies and enrolls indigent and under-insured patients into drug assistance reimbursement programs which provide drug replacement and reimbursement compensation. Monitors continued eligibility status and documents drug shipments received in computerized tracking system. Serves as a resource in facilitating resolution of insurance denial referrals. Communicates effectively with pharmacy, hospital administration, medical staff, patients and personnel in the patient assistance programs using verbal and written interpersonal communication skills. Requires ability to work independently and coordinate assigned projects efficiently. Effectively utilizes problem-solving ability, significant interpersonal contact and concentration abilities, analytical skills and in depth knowledge of computer software. Coordinates all information regarding patients enrolled in assistance programs for drug therapies using various computer software programs. Creates, expand and maintains computerized databases to support patient enrollment in assistance programs and tracks case specific assistance provided in response to reimbursement denials. Conducts patient interviews and conveys reimbursement denial potential to patient and medical staff. Reviews all outpatient 3rd party rejections and assists the patient in resolving the problem. Coordinates 3rd party billing, problems with eligibility, rejections, etc. with the Outpatient Pharmacy Supervisor and the Pharmacy Billing Section.

EDUCATION/EXPERIENCE
Texas State Board of Pharmacy registration required. National Certification as a Certified Pharmacy Technician (CPhT) is recommended. Three years experience in a medical or pharmacology related field to include project coordination; database/spreadsheet development and management; and/or application programming; processing and overseeing medical insurance billing and reimbursement cost capture. Must have demonstrated independent judgment.

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