Revenue Cycle Denial Specialist

Job Summary

Working remotely in a full-time capacity, the Revenue Cycle Denial Specialist will review, analyze, and resolve post-billed denials and rejections for hospital and professional claims, ensuring accurate reimbursement and denial prevention while collaborating with various departments.

Key responsibilities

• Analyze denials to determine root cause and develop appropriate resolution strategies
• Prepare and manage payer appeals within required timelines, ensuring compliance with regulations
• Collaborate with coding, billing, and operational teams to address denial drivers and improve workflows

Required qualifications

• Associate's degree or Certification in Healthcare Business, or equivalent combination of education and experience
• Three (3) years of healthcare experience in a revenue cycle position
• Three (3) years of experience with ICD-10 coding and related guidelines
• Proficiency in Microsoft Office applications, particularly advanced Excel
• Experience with payer portals and denial/appeals tracking tools