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Insurance Denial Jobs (NOW HIRING)

Cherry Tree Dental

Revenue Cycle Specialist

Madison, WI · On-site

Claim Prevention and Denial Resolution * Proactively identify insurance setup or eligibility issues that may result in claim denials. * Partner with billing and accounts receivable teams to correct ...

EvergreenHealth

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

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$28K

$62.3K

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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
Specialist-Authorization Denial

Specialist-Authorization Denial

Baptist Memorial Health Care Corporation

Memphis, TN

$18.75 - $25/hr

Other

Posted 4 days ago

Baptist Memorial Health Care rating

7.3

Company rating: 7.3 out of 10

Based on 110 frontline employees who took The Breakroom Quiz

290th of 864 rated healthcare providers

Job description

Purpose of Position and Scope of Responsibility

Authorization Denial Specialist ensures that chemotherapy (specialty group) and other infusions/radiation therapy/radiology/ surgical services meet medical necessity and appropriateness per insurance medical policies/ FDA/NCCN guidelines. Initiates and coordinates pre-certifications/prior authorizations per payer guidelines prior to services being rendered and completes the Insurance verification process.

Reviews clinical information and supporting documentation for outpatient or Part B services authorization denials to determine and perform retro authorizations, reconsiderations or appeal actions to defend the revenue. Performs other duties as assigned.

Principal Accountabilities/Responsibilities
  • Obtain and review treatment/therapy plan orders for medical necessity and appropriateness according to insurance medical policy/FDA/NCCN guidelines and requirements.
  • Research insurance company medical policies, medical literature, and compendiums to determine eligibility for services. Utilize multiple healthcare websites.
  • Track, obtain, and extend authorizations from various carriers in a timely manner.
  • Complete the Insurance Verification process.
  • Works closely with physicians and clinic staff obtain authorizations to promote positive patient outcomes, timely treatment and positive reimbursement.
  • Understands and complies with regulatory requirements by specific insurance companies and facilitates compliance by maintaining awareness of guidelines and ensuring compliance through communication and documentation to appropriate staff.
  • Reviews, assesses and evaluates all authorization denial communications received in order to optimize reimbursement.
  • Collaborates with denial team to education denial specialists and clinical staff on trending in authorization and medical necessity denials.
  • Complete other duties as assigned.
Minimum Qualifications

3 - 5 years of business experience in a healthcare environment with 2 of those years being in a clinical setting.

Desired Qualifications

5 years of business experience in a healthcare environment with at least 3 years payer specific experience.

3 years clinical experience in a clinical care setting

Pre-certification experience desired.

What Baptist Memorial Health Care employees say

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Hours and flexibility

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About Baptist Memorial

Sourced by ZipRecruiter

Baptist Memorial, based in Memphis, TN, US, is a leading health care organization renowned in the healthcare industry. The company's official website is baptistonline.org which provides a comprehensive view of their services and operations. Baptist Memorial operates a myriad of hospitals, health clinics, and medical facilities providing expert and compassionate care. Founded in 1912, it has a rich legacy of over a hundred years of dedication to its community, offering services which include acute care, diagnostic services, and a broad range of speciality health services fulfilling various patient needs.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Memphis, TN, US

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