US Healthcare Claim Denial Specialist

7 days ago

Islamabad, Islamabad, Pakistan beBeeHealthcareDenialExpert Full time $80,000 - $123,456
US Healthcare Claim Denial Expert

We are seeking a highly skilled professional to fill this position in the US healthcare industry.

The ideal candidate will have expertise in the US healthcare system and insurance processes, particularly for mental and behavioral health claims. This role is responsible for analyzing denied insurance claims to ensure timely reimbursement and minimize revenue cycle delays.

Key Responsibilities:
  • Review Explanation of Benefits (EOBs) and denial codes to identify accuracy and potential appeal opportunities.
  • Contact insurance companies to understand denial reasons and clarify claim status.
  • Prepare and submit corrected claims and appeals accompanied by supporting documentation.
  • Collaborate with internal teams to resolve recurring issues related to billing, eligibility, and provider interactions.
  • Track and follow up on outstanding appeals and reprocessed claims.
  • Maintain detailed records in the billing system and report denial trends or payer issues.
Qualifications:
  • A minimum of 2+ years of experience handling claim denials and appeals in a healthcare billing or revenue cycle setting.
  • Strong understanding of mental health billing codes, parity laws, and payer requirements (e.g., CPT, ICD-10, modifiers).
  • Familiarity with insurance portals (e.g., Availity, payer sites) and clearinghouses.
  • Knowledge of HIPAA, insurance EOBs, and denial management best practices.
  • Detail-oriented, organized, and capable of managing multiple priorities independently.
  • Excellent communication and documentation skills.

This is an excellent opportunity to grow professionally and make a positive impact in the healthcare industry.

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