Description The Hospital Denials Specialist is responsible for reviewing, analyzing, and resolving denied or underpaid claims from insurance payers. This role requires strong analytical abilities, knowledge of healthcare billing processes, and an understanding of reimbursement practices to minimize financial risks and optimize revenue outcomes. You will collaborate with various stakeholders, including payers and internal departments, to research and appeal claim denials while ensuring compliance with all regulatory requirements. Key Responsibilities: + Analyze and review denied claims to determine the root cause and take corrective action. + Prepare, submit, and track appeals for denied or underpaid claims in compliance with payer-specific guidelines and deadlines. + Communicate with insurance companies to resolve denials, underpayments, or payment delays. + Collaborate with internal departments, such as medical billing, coding, and clinical teams, to obtain necessary documentation for appeals submissions. + Stay current on payer policies, coding guidelines, and reimbursement rules to ensure compliance. + Identify any trends or patterns in claim denials and provide feedback to leadership for process improvement. + Utilize billing and claims management software to track denials and prepare detailed reports on denial management metrics. + Maintain strict adherence to HIPAA regulations and other applicable laws regarding patient data privacy and security. Requirements + Minimum 2-3 years of experience in healthcare billing, reimbursement, or denial management, preferably in a hospital or similar setting. + Proficiency with electronic medical records (EMR) systems and billing software, such as Epic, Cerner, or similar platforms. + Strong understanding of medical terminology, coding (ICD-10, CPT, HCPCS), and payer reimbursement guidelines. + Exceptional problem-solving and analytical skills with the ability to identify trends and recommend solutions. + Excellent written and verbal communication skills to effectively interact with payers and internal teams. + Strong organizational and time-management skills with the ability to prioritize and meet deadlines in a fast-paced environment. Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more. Robert Half will consider for employment qualified applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. © 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .