Denials Management Specialist

Job Summary

Supporting essential revenue cycle operations, the full-time remote Denials Management Specialist will focus on denials resolution, payer follow-up, reimbursement recovery, and account receivable reduction while managing denied accounts and submitting appeals as necessary.

Key responsibilities

• Research denied accounts to identify root causes and resolve payer barriers
• Submit appeals or reconsiderations for denied claims and escalate complex issues requiring intervention
• Maintain productivity metrics reflecting significant cash collections and account resolution

Required qualifications

• Minimum of 4 years of recent healthcare revenue cycle experience, particularly in hospital billing and denials resolution
• HFMA Certified Revenue Cycle Representative (CRCR) required or to be obtained within 120 days of employment
• Expert knowledge of medical insurance and relevant billing regulations
• Extensive experience in insurance claims appeals and coding guidelines
• Proficiency in Excel, Word, and Outlook