Denials Specialist

LaSalle Intelligent Solutions is partnering with our client to hire a Denials Specialist in Skokie, Illinois, for a contract-to-hire opportunity. This Denials Specialist role is a strong fit for someone who enjoys owning end-to-end denial and appeal workflows while also driving reporting, data integrity, and cross-functional collaboration. In this Denials Specialist position, you’ll support denial prevention and revenue protection across multiple payor types and stay current on evolving regulatory requirements. Our client offers a growth-focused environment with strong leadership, and this role is fully remote after an initial on-site training period. Please note: this role requires fully on-site training in Skokie for the first 1-2 week, and then transitions to fully remote immediately after training. Responsibilities

• Oversee denial and appeal workflows using a denial management system, including documentation, deadline tracking, and timely payment/adjustment processing
• Audit denial data to correct errors, maintain data integrity, and build standard and ad-hoc reports to identify trends and variances
• Perform denial root-cause analysis and provide feedback and education to departments and provider offices to reduce denials and improve processes
• Maintain current knowledge of Medicare, Medicaid, and managed care requirements by monitoring CMS guidance and industry changes
• Serve as a liaison across departments and off-site facilities to support denial prevention and optimal reimbursement
• Perform RAC account review and reconciliation, including appeals for medically unlikely edits (MUE) rejections and related adjustments/refunds as appropriate
• Complete adjudication-related work, including calculating allowances, identifying contract inconsistencies, and correcting account/insurance errors Qualifications
• High school diploma or equivalent required; associate degree in business, accounting, or healthcare (or bachelor’s degree) preferred
• At least 3 years of experience in adjudication, reimbursement, denial management, utilization review, or similar experience in a healthcare environment
• Epic experience required
• Knowledge of reimbursement models and related federal/state/regulatory requirements, including Medicare, Medicaid, and managed care
• Proficiency with Microsoft Office products and comfort working in databases, report writing, and multiple payer portals/systems
• Familiarity with claims processing and coding concepts (CPT, HCPCS, DRGs, and ICD-9/10) and strong writing skills to draft clear, persuasive appeal letters Key Details
• Employment Type: Contract-to-Hire
• Compensation: $26 – $28 per hour
• Benefits (Contract): LaSalle Intel consultants are eligible to enroll in benefits. For details, visit: https://www.thelasalleintel.com/consultants/
• Location: Skokie, IL
• Work Model: Fully Remote Ready to take the next step in your career? Apply today - we're actively interviewing and excited to meet you. Jessica Xiques Recruiter #LNAF