Transcend Health Solutions, LLC ยท 1 day ago
Denials Claims Analyst
Bradenton, FL
Full-time
Onsite
Entry, Mid Level
$18/hr - $22/hr
2+ years expTranscend Health Solutions, LLC is seeking a Denials Claims Analyst with expertise in commercial and governmental payor guidelines. The role involves investigating, submitting, and resolving claims while ensuring compliance and maintaining productivity goals.
Hospital & Health Care
Responsibilities
Review and process denials and underpayments of claims by reviewing and gathering medical records and patient information
Submit claims to commercial and governmental payors in accordance with billing rules
Verify eligibility, claim status, and payer responsibility with adjusters
Communicate professionally with insurance adjusters and patients to resolve claim barriers and expedite processing
Review Explanation of Benefits (EOBs) or remittance advices for accuracy and next steps
Prepare and submit appeals when claims are denied or underpaid, referencing applicable rules and documentation
Ensure all activities are documented clearly and timely in claim management systems
Maintain compliance with HIPAA and confidentiality standards
Escalate complex claim issues or legal barriers to leadership as needed
Meet productivity goals while maintaining excellent attendance, attention to detail, and accuracy
Qualification
Required
Expert knowledge of commercial and governmental claims processes, including writing effective appeals and reconsiderations
Strong knowledge of medical terminology, coding (ICD-10, CPT, HCPCS), and healthcare billing principles
Excellent communication and problem-solving skills
Experience handling claims from submission through resolution
Proficiency in interpreting EOBs, fee schedules, and medical documentation
Ability to communicate clearly and professionally with adjusters, patients, and healthcare providers
Highly organized and detail-oriented with excellent follow-up skills
Proven track record of excellent attendance and reliability
High School Diploma required; Bachelor's degree preferred, or equivalent combination of education and experience
Minimum of 2 years experience in medical billing or claims resolution
Preferred
Familiarity with commercial and governmental payor portals (e.g., Availity, Humana, etc.)
Experience with coordination of benefits, reconsiderations and appeals
Proficiency in Microsoft Office
Knowledge of medical terminology and ICD-10/CPT coding
Understanding of authorization and referral processes
EHR experience
Benefits
Competitive salary commensurate with experience
Comprehensive benefits package (medical, dental, vision)
Paid time off and holidays
Career development and training opportunities
Supportive, mission-driven team environment
Company
Transcend Health Solutions, LLC
Transcend Health Solutions specializes in revenue cycle management (RCM) services.
11-50 employees
Funding
Current Stage
Early StageLeadership Team
W. Charles Day
Chief Executive Officer
Stephen Ingram
Chief Technology Officer
Company data provided by crunchbase