Medical Denials & Collection Specialist

Medical Denials & Collections Specialist

Job description:

Gentell, Inc. and its affiliated companies, Wound Care Concepts and Absolute Wound Solutions, are a national provider of advanced wound care and ostomy/urology/tracheostomy (OUT) products to the long-term care industry. Garnering a more than 99% customer satisfaction rate, our Total Wound Care Solution is a comprehensive program that improves patient outcomes, controls costs to our partner facilities and reduces nursing time. You would be joining a team dedicated to making it better every day.

We are seeking aDenials & Collections Specialistto join our Revenue Cycle Management (RCM) team. In this role, you will be responsible for managing insurance denials, following up on outstanding accounts receivable, and ensuring timely resolution of unpaid claims.

Responsibilities:

• Review and resolve claim denials by analyzing EOBs/ERAs.
• Prepare and submit appeals to payers within deadlines.
• Follow up with insurance companies and patients on unpaid balances.
• Document all actions taken in the billing/RCM system.
• Collaborate with billing, coding, and posting teams to reduce recurring denials.

Required Skills/Abilities:

• 2+ years of U.S. healthcare RCM experience in denials and AR collections.
• Knowledge of Medicare, Medicaid, and commercial payer guidelines.
• Familiarity with CPT, ICD-10, and medical billing software.
• Strong communication and negotiation skills.
• Detail-oriented with a problem-solving mindset.