Denial Coordinator

Insight Global is looking for a Denial Coordinator to support a large hospital system in the Maryland/DC area. This person will support the Denials Appeals and Performance team, a centralized hospital denial team serving 10 hospitals. This role is hospital‑based and denial‑type driven, with work assigned via CARC codes rather than by inpatient or outpatient setting. Denials primarily include no‑authorization (technical) and medical necessity / level‑of‑care (clinical) denials. Denial Coordinators work closely with RN reviewers and fellow technical staff in a fast‑paced, collaborative environment.
This is a production‑focused role, with an expected daily volume of approximately 40 appeals per day, varying in complexity.

Primary Responsibilities:
- Work hospital denial accounts routed through proprietary system based on denial reason
- Review denial letters to determine appeal feasibility and next steps
- Draft and submit clear, detailed appeal letters for:
• No‑authorization denials (technical)
• Medical necessity and level‑of‑care denials (in partnership with RNs)
- Collaborate daily with:
• RN reviewers
• Other denial coordinators
• Leadership and managed care partners as needed
- Maintain timely follow‑up on appealed accounts to ensure resolution
- Identify denial trends and escalate issues appropriately
- Participate in:
• Daily huddles
• Case review meetings
• Interdisciplinary denial discussions
- Support special projects related to denial trends, payer behavior, or backlog reduction
- Adapt to evolving workflows as the DAP team continues to build and scale

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

· High school diploma or equivalent
· Facility/hospital billing experience (not physician or professional)
· 3+ years of hospital denial management experience
• Post‑billing denials and appeals (not front‑end access only)
· Hands‑on appeal writing experience
• Ability to build a case using denial letters, payer policy, and supporting documentation
• Not limited to form or template‑only appeals
· Ability to thrive in a high‑volume, production‑driven environment (target ~40 appeals/day)
· Experience with prior authorization–related denials and insurance follow‑up
· Experience working within payer portals (e.g., Availity, EVS, payer‑specific portals)
· Comfort navigating multiple systems and workflows simultaneously
· Strong attention to detail with the ability to work quickly and accurately
· Experience collaborating with clinical staff (RNs, UR, case management)

- Familiarity with CARC (claim adjustment reason) codes and denial‑reason–based work routing
- Experience with UB‑04 forms
- Experience with systems such as:
• RCI (denial repository)
• Epic
• Med‑Connect (medical records)
• Envision / SMS
- Experience with Maryland and/or Washington, DC reimbursement
- Certifications:
• CHAA (Certified Healthcare Access Associate)
• CRCS‑I (Certified Revenue Cycle Specialist – Insurance)

Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.