Denial Resolution Specialist

Job Summary

Working remotely on a full-time basis, the Denial Resolution Specialist will analyze denied claims, develop resolution strategies, and collaborate with a multi-disciplinary team to enhance revenue cycle performance.

Key responsibilities

• Review and analyze denied claims to determine appropriate resolution or appeal strategies
• Prepare and submit compliant appeal documentation for non-clinical denials while tracking retrospective authorization requests
• Identify denial trends and root causes, communicating findings to support process improvement and prevention efforts

Required qualifications

• High school diploma or GED required; Associate's degree preferred
• 4+ years of experience in medical billing, revenue cycle operations, or denial and appeals management
• Experience within a hospital or health system revenue cycle environment required
• Working knowledge of payer guidelines, reimbursement methodologies, and denial/appeal processes
• Proficiency in Microsoft Office applications and revenue cycle systems; Epic experience required