Denials Specialist
11 days ago
Knoxville
Job Description Denials Specialist Pay: $17-$18/hr Job Type: Full-Time Location: Knoxville, TN Schedule: Monday–Friday Position Overview M Force Partners is seeking a detail-oriented Denials Specialist to support a healthcare Revenue Cycle team. This role focuses on reviewing, analyzing, and resolving denied insurance claims to ensure timely reimbursement and reduce future denials. The ideal candidate will have strong experience in medical billing, payer guidelines, and appeals processes while maintaining accuracy and compliance in a fast-paced billing environment. Key Responsibilities • Review and resolve denied or rejected insurance claims in a timely manner, • Research and resolve denied claims by identifying billing errors, missing information, and payer-specific requirements, • Analyze denial codes and determine root causes such as coding issues, authorization problems, or eligibility discrepancies, • Review coding, procedures, and claim data to determine denial causes and coordinate corrections with coding or billing teams, • Prepare and submit appeals and reconsiderations with appropriate documentation, • Correct and resubmit claims for timely reimbursement, • Communicate with insurance companies and payer representatives to resolve claim discrepancies, • Verify insurance eligibility and benefits through payer portals, ensuring accuracy within billing systems such as Cerner, • Track denial trends and recurring issues and report findings to leadership to improve billing processes, • Collaborate with billing, coding, and clinical teams to prevent recurring denials, • Ensure compliance with payer guidelines, contracts, and timely filing limits, • Maintain accurate documentation of claim follow-up activity and resolution status Required Qualifications • 2+ years of experience in appeals and denial management, • Strong understanding of Explanation of Benefits (EOBs), • Basic knowledge of CPT, ICD-10, and HCPCS coding, • Familiarity with insurance payer policies including Medicare, Medicaid, and commercial payers, • Experience submitting appeals and claim follow-ups, • Strong analytical and problem-solving skills, • Excellent communication and organizational skills Preferred Qualifications • Experience using EMR/EHR systems such as Cerner, eClinicalWorks, Epic, or similar platforms, • Experience working within Revenue Cycle Management processes Job presented by M Force Partners M Force Partners is a specialized recruitment partner connecting top-tier talent with leading organizations. With a deep understanding of engineering/technical, medical, professional and executive disciplines and industry demands, we deliver tailored recruitment solutions, including direct hire and contract placements, to ensure the right fit for both candidates and clients. If this role isn’t the right fit for you, we encourage you to explore our other opportunities at mforcepartners.com. Do you know someone who may be a great match? Feel free to share this opportunity within your network. Equal Opportunity Employer M Force Partners is an Equal Opportunity Employer. Employment decisions are based on qualifications, merit, and business needs. Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions. Company DescriptionM Force Partners is a specialized recruitment partner connecting top-tier talent with leading organizations. With a deep understanding of engineering/technical, medical, professional and executive disciplines and industry demands, we deliver tailored recruitment solutions, including direct hire and contract placements, to ensure the right fit for both candidates and clients. If this role isn’t the right fit for you, we encourage you to explore our other opportunities at mforcepartners.com. Do you know someone who may be a great match? Feel free to share this opportunity within your networkM Force Partners is a specialized recruitment partner connecting top-tier talent with leading organizations. With a deep understanding of engineering/technical, medical, professional and executive disciplines and industry demands, we deliver tailored recruitment solutions, including direct hire and contract placements, to ensure the right fit for both candidates and clients.\r\n\r\nIf this role isn’t the right fit for you, we encourage you to explore our other opportunities at mforcepartners.com.\r\n\r\nDo you know someone who may be a great match? Feel free to share this opportunity within your network