Denial Prevention Specialist

Weatherford, TX - USA

Monthly Salary: $ 20 - 22

Posted on: 2 hours ago

Vacancies: 1 Vacancy

Job Summary

Application Deadline: Feb. 28 2026
Weatherford
Remote
Hourly salary: $20 - $22

Job Description

Responsibilities :

The successful candidate will review research and resolve claim denials and appeals for various insurance companies while identifying payment trends in an effort to maximize collections. A successful candidate should have but not be limited to the following skills:
Capable of reviewing Explanation of Benefits (EOB) from payors to determine how the claims were managed.
Contacting insurance carriers to check on the status of claims appeals and insurance verification.
Knowledgeable with payors including Managed Care Commercial Medicare and Medicaid
Preparing/Submitting appeals related to denied services
Analyze payer denials by denial groupers and submit appeals.
Contact patients and/or third party payers to resolve outstanding insurance balances and underpaid claims.
Make necessary adjustments as required by plan reimbursement.
Functions as a liaison between clinical departments and MSRDP management team.
Completes special projects as assigned.
Performs other duties as assigned.

Required Skills:

High School Diploma or Associates Degree
2 years experience in medical claims recovery and/or collections required
Work requires a self-starter with ability to work well as part of a team and independently.
Work requires ability to communicate effectively with patients insurance companies clinical staff and management.
Work requires ability to handle large volumes of work.
Work requires ability to work in a fast paced production oriented environment.
Work requires excellent customer service skills.
Work requires experience in Medical Billing Accounts Receivables and/or Collections within a healthcare or insurance environment.
Work requires good organizational flexibility and analytical skills when resolving more complex unpaid claims.
Work requires knowledge of billing and/or collections and regulations.
Work requires knowledge of CMS 1500 ICD-9 and CPT coding is preferred.
Work requires one to exhibit excellent work ethics and commitment to job responsibilities.
Work requires one to possess a professional and courteous demeanor while being assertive and confident in their collection efforts.
Work requires one to possess quick and accurate alpha/numeric data entry skills.
Work requires presence of a positive image that reflects well on the organization.
Work requires strong written and verbal communication skills.
Work requires understanding of the requirements of Medicaid Medicare and insurance billing.

Required Experience:

Application Deadline: Feb. 28 2026 WeatherfordRemoteHourly salary: $20 - $22Job DescriptionResponsibilities :The successful candidate will review research and resolve claim denials and appeals for various insurance companies while identifying payment trends in an effo...

Application Deadline: Feb. 28 2026
Weatherford
Remote
Hourly salary: $20 - $22

Job Description

Responsibilities :

The successful candidate will review research and resolve claim denials and appeals for various insurance companies while identifying payment trends in an effort to maximize collections. A successful candidate should have but not be limited to the following skills:
Capable of reviewing Explanation of Benefits (EOB) from payors to determine how the claims were managed.
Contacting insurance carriers to check on the status of claims appeals and insurance verification.
Knowledgeable with payors including Managed Care Commercial Medicare and Medicaid
Preparing/Submitting appeals related to denied services
Analyze payer denials by denial groupers and submit appeals.
Contact patients and/or third party payers to resolve outstanding insurance balances and underpaid claims.
Make necessary adjustments as required by plan reimbursement.
Functions as a liaison between clinical departments and MSRDP management team.
Completes special projects as assigned.
Performs other duties as assigned.

Required Skills:

High School Diploma or Associates Degree
2 years experience in medical claims recovery and/or collections required
Work requires a self-starter with ability to work well as part of a team and independently.
Work requires ability to communicate effectively with patients insurance companies clinical staff and management.
Work requires ability to handle large volumes of work.
Work requires ability to work in a fast paced production oriented environment.
Work requires excellent customer service skills.
Work requires experience in Medical Billing Accounts Receivables and/or Collections within a healthcare or insurance environment.
Work requires good organizational flexibility and analytical skills when resolving more complex unpaid claims.
Work requires knowledge of billing and/or collections and regulations.
Work requires knowledge of CMS 1500 ICD-9 and CPT coding is preferred.
Work requires one to exhibit excellent work ethics and commitment to job responsibilities.
Work requires one to possess a professional and courteous demeanor while being assertive and confident in their collection efforts.
Work requires one to possess quick and accurate alpha/numeric data entry skills.
Work requires presence of a positive image that reflects well on the organization.
Work requires strong written and verbal communication skills.
Work requires understanding of the requirements of Medicaid Medicare and insurance billing.

Required Experience:

Key Skills

Sales Experience
Crane
Customer Service
Communication skills
Heavy Equipment Operation
Microsoft Word
Case Management
OSHA
Team Management
Catheterization
Microsoft Outlook Calendar
EHS

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About Company

SGA

About the company SGA is a technology and resource solutions provider driven to stand out. We are a women-owned business. Our mission: to solve big IT problems with a more personal, boutique approach. Each year, we match consultants like you to more than 1,000 engagements. When we say ... View more

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