Claims Denial and Appeals Specialist

Grand Rapids, MI
Medical Staffing
Employee Type:
Full Time
Required Experience:
1 Years
Required Education:
Highschool Diploma or Equivalent
Travel Required:

Diversified Medical Staffing is a leading healthcare staffing solutions provider based in West Michigan. Since 1985, we have focused on bringing the highest level of quality, dedication, and professionalism to both our clients and employees. Our employees are the reason for our success! We offer dynamic, fast-paced work environments for energetic, dedicated employees. We value our employees’ time and unique talents; promoting a strong work-life balance and flexible work environment. DMS Recruiters are always available to discuss your career potential – let us market you to the hundreds of health care clients we serve!

In addition to career advancement, here are some of the benefits we provide to our professional temporary employees:

  • Competitive salary
  • Weekly checks – with direct deposit
  • Employee Referral Bonuses
  • 401(k) Program
  • Holiday Pay, when applicable

DMS has a full time, temp-to-hire position available for a Claims Denial and Appeals Specialist in Grand Rapids, MI. This position is responsible for maintaining up to date patient records, responding to insurance and patient inquiries, analyzing and pursuing past due payments and handling insurance claim denials, rejections, and resubmission of claims. 

Essential Functions and Responsibilities for this position include:

  • Reviewing and analyzing claim denials in order to perform the appropriate appeals necessary for reimbursement
  • Receives denied claims and researches appropriate appeal steps
  • Communicates with payor, resubmits denied claims, underpaid claims and clams that are inaccurately processed
  • Tracks and documents all denials by payor, visit type and denial category
  • Recommends process improvements or system edits to eliminate future denials
  • Process patient refunds in a timely manner

Requirements include:

  • High School Diploma, GED, or equivalent
  • College Education: 1-2 years preferred or equivalent vocational training
  • Knowledge of CPT, ICD-9/10-CM, HCPCS and modifiers necessary
  • Extensive knowledge of third party billing and payment methodologies required
  • Experience with computerized patient accounting systems
  • Knowledge of HIPAA guidelines and requirements
  • Excellent written and verbal communication skills

Apply Online