Denial Prevention Specialist

Are you a sharp healthcare finance or billing professional with a talent for solving complex claims and overturning denied services? We are seeking a dedicated Denial Prevention Specialist to join our dynamic team! In this high-impact role, you will review, research, and resolve claim denials and appeals for major insurance carriers while analyzing payment trends to maximize revenue recovery.

Enjoy the flexibility of a hybrid work schedule with a daily flexible start time between 6:00 AM and 9:00 AM! This role is primarily remote (work from home), with occasional on-site visits in the DFW area for equipment pickup, team-building events, or office meetings. If you bring a strong background in physician billing, hands-on experience writing and submitting appeals, and an assertive, confident approach to collections, we want to hear from you.

salary: $23.63 - $23.64 per hour
shift: First
work hours: 6 AM - 3 PM
education: High School

Responsibilities

Position Summary:

Analyze, research, and resolve insurance claim denials and underpaid accounts. Prepare and submit formal appeals, evaluate Explanation of Benefits (EOB) statements, and liaise with clinical departments and payers to maximize collections.

Key Responsibilities:

• Review EOBs to analyze payer denials and prepare/submit formal appeals for denied services.

• Contact insurance carriers to verify coverage, check appeal status, and resolve underpaid claims.

• Make necessary financial adjustments based on plan reimbursement guidelines.

• Function as an operational liaison between clinical departments and management teams.

Requirements:

• High School Diploma or GED required (Associate degree preferred).

• 2+ years of recent experience in medical claims recovery, collections, or physician billing.

• Demonstrated hands-on experience preparing and submitting insurance appeals.

• Solid understanding of Managed Care, Commercial, Medicare, and Medicaid guidelines.

• Must reside in the Greater DFW area for periodic on-site training and meetings.

Skills

• Analytical Thinking
• Denial Management
• Basic Software Skills
• Written Communication

Qualifications

• Years of experience: 2 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected].

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.