About the Medical Denials Specialist Role at Robert Half

Join our dynamic healthcare team at Robert Half in Carmel, Indiana, as a Medical Denials Specialist. This full-time position offers a Monday–Friday schedule from 8:00 am to 5:00 pm, providing a stable and predictable work-life balance in the heart of the Midwest. As a key player in our revenue cycle management, you'll dive into the complexities of denied medical claims, turning rejections into reimbursements and driving financial efficiency for healthcare providers. Robert Half, a leader in staffing and consulting, connects top talent like you with rewarding opportunities in the booming healthcare sector.

In this role, you'll work in a fast-paced environment where attention to detail and proactive problem-solving are paramount. Medical denials are a persistent challenge in healthcare billing, often due to coding errors, missing documentation, or payer policy changes. Your expertise will ensure claims are resolved swiftly, minimizing revenue loss and supporting patient care funding. With Carmel, IN's growing healthcare hub—home to top hospitals and clinics—this position places you at the forefront of innovative claims management practices.

Why Medical Denials Specialists Are in High Demand

The healthcare industry faces increasing scrutiny on claims processing, with denial rates averaging 10-15% industry-wide. Specialists like you are essential for navigating evolving regulations from Medicare, Medicaid, and private insurers. Robert Half's clients value professionals who can reduce denials through data-driven insights, making this role pivotal for operational success and career advancement.

Key Responsibilities

As a Medical Denials Specialist, your impact will be immediate and measurable. Here's what you'll tackle daily:

• Review and Research Denials: Analyze insurance denial letters (EOBs), payer portals, and patient records to pinpoint issues like bundling errors or medical necessity lacks.
• Trend Analysis and Improvements: Track denial patterns using Excel or specialized software, identifying root causes such as registration errors or prior authorization gaps, and propose actionable fixes to billing leadership.
• Payer Negotiations: Directly engage with representatives from Aetna, UnitedHealthcare, Blue Cross Blue Shield, and others via phone, email, or portals to overturn denials and expedite payments.
• Appeal Mastery: Craft compelling appeals with supporting clinical documentation, coding corrections, and payer-specific arguments, aiming for high resubmission success rates.
• Cross-Functional Collaboration: Partner with coders, billers, providers, and compliance teams to close the feedback loop on claims issues.
• Regulatory Vigilance: Stay abreast of CMS updates, ICD-10/11 changes, and payer policy shifts through continuous education.
• Compliance Assurance: Uphold HIPAA privacy rules, documenting all interactions securely to mitigate audit risks.

Expect to handle 50-100 claims daily, prioritizing high-dollar denials for maximum ROI.

Required Qualifications

To excel, bring these qualifications to the table:

• 2+ years in medical billing, AR follow-up, or denials resolution.
• Familiarity with CPT, HCPCS, ICD-10 coding, and modifiers.
• Tech-savvy with EHR systems (Epic, Cerner), clearinghouse tools (Availity, Change Healthcare), and MS Office Suite.
• Sharp analytical skills for dissecting complex denial reasons.
• Superior written/verbal communication for persuasive appeals and payer dialogues.
• HIPAA certification or equivalent knowledge preferred.
• Bachelor's in Health Information Management a plus.

Robert Half seeks motivated self-starters ready to thrive in a collaborative setting.

Why Join Us at Robert Half?

Robert Half offers more than a job—it's a launchpad for your healthcare career. Enjoy competitive pay around $18/hour (equating to $37,000-$42,000 annually), full benefits including health coverage, 401(k) matching, PTO, and professional growth via training. Work in upscale Carmel, IN, with its vibrant community, low cost of living, and proximity to Indianapolis. Our supportive culture emphasizes work-life balance, diversity, and innovation. SEO keywords: medical denials jobs Carmel IN, healthcare billing careers, claims appeals specialist Robert Half. Apply now and resolve denials while advancing your future! (Word count: 812)