Certified Denial Specialist

Job Summary

To support efficient revenue cycle operations, the full-time remote Senior Denial Specialist will manage the timely resolution of denied claims, conduct root-cause analysis, and serve as a mentor while collaborating with leadership on complex denial issues.

Key responsibilities

• Resolve a broad range of denied claims in compliance with contracts and regulations
• Conduct root-cause analysis to identify mitigation opportunities for denied claims
• Collaborate with leadership to escalate trends and issues related to denial processes

Required qualifications

• High School diploma or GED equivalent
• Five years of progressively responsible experience in healthcare revenue cycle, with three years in denial management
• Working knowledge of government and non-government payer requirements and reimbursement rules
• Proficiency in Epic Hospital and/or Professional Billing; Epic reporting preferred
• CPC or CRCR certification required upon hire