Clinical Denial Specialist

A company is looking for a Clinical Denial Specialist. Key Responsibilities Receive, triage, and prioritize denied hospital claims based on various factors Conduct root cause analysis to identify reasons for denial and coordinate with relevant teams Assemble and submit appeal packets, ensuring compliance with clinical documentation and payer requirements Required Qualifications Associate or bachelor's degree in healthcare administration, medical assistant, health information management, or a related field Prior experience in hospital revenue cycle, clinical denials, appeals, or medical claims processing Strong understanding of payer denial codes and hospital billing processes