Insurance Denial Specialist

Complete Care is a multi-disciplinary practice serving patients who have physical injuries as a result of trauma. Complete Care and its family of practices are characterized by core competencies of cultural, clinical and operational excellence. We strive to meet every patients' individual needs with skillfulness and professionalism.  

Role Overview

We are seeking a detail-oriented and analytical Insurance Denial Specialist to join our growing team. In this role, you will be responsible for investigating and resolving denied, underpaid, or unresolved insurance claims. Your expertise will help ensure timely resolution, reduce denial rates, and support the financial health of our organization.

Key Responsibilities

• Research and resolve denied, underpaid, or unresolved insurance claims

• Collaborate with insurance carriers and counsel to appeal denials and negotiate adjustments

• Monitor and report on billing metrics to identify trends and improve claim resolution times

• Utilize AR, underpayment, and monthly reports to track claim status and ensure accuracy

• Maintain accurate claim documentation for reporting and compliance purposes

• Communicate insights on denial trends with the team and leadership for process improvements

• Provide support to colleagues on complex denial cases and best practices

• Stay updated on industry regulations, policies, and trends impacting claim management

Qualifications

• Proven experience in insurance claims processing or denial management

• Strong analytical and problem-solving skills

• Excellent communication and interpersonal skills

• Detail-oriented with a focus on accuracy and efficiency

• Familiarity with healthcare insurance policies and procedures

• Ability to provide language translation support (as needed) for effective patient communication