Revenue Specialist, Denials

Job Summary

Reviewing denied claims and facilitating their resolution, the full-time Revenue Specialist, Denials will manage the denial audit process and ensure proper documentation for reimbursement while working remotely.

Key Responsibilities

• Review and evaluate denied claims using proprietary software to determine correct reimbursement
• Research and acquire necessary medical records to support claims submissions to payers
• Conduct follow-up communications with payers to confirm receipt of claims and documentation

Required Qualifications

• High School Diploma or GED required; Associates or Bachelor's Degree preferred
• 5+ years of experience in healthcare billing or collections
• 1+ years of client-facing or customer service experience
• Intermediate understanding of insurance claims processing and medical terminology
• Proficiency in MS Office applications and familiarity with hospital billing forms