🏠 Fully Remote | California-Based Candidates Preferred
💵 $22–$24/hour + Benefits
💡 The Role
As a Denial Management Specialist, you’ll be the insurance whisperer on the Revenue Cycle team—tracking down complex third-party denials, navigating payer appeal processes, and turning “no” into “paid in full.” You’ll work cross-functionally to maximize reimbursement, identify root causes, and craft detailed appeals backed by clinical logic and contract language.
📌 What You’ll Be Doing
• 🔍 Investigate third-party denials and resolve claims with precision
• 📄 Write and submit customized appeals based on EOBs, clinical documentation, and payer policy
• ☎️ Contact payers via phone, web portal, or letter to clarify, follow up, and resolve denials
• 🧠 Determine action based on denial type (authorization, appeal, or no action)
• 💻 Access payer portals like Navinet and Availity to upload appeals and gather data
• 📊 Track appeal outcomes, flag recurring denial patterns, and report trends
• 🤝 Collaborate with financial engagement teams, physicians, insurance reps, and practice staff
• 🔐 Maintain HIPAA compliance and uphold patient confidentiality at all times
• 🧾 Escalate exhausted accounts to management based on policy
🎯 What You’ll Need
• 🎓 Bachelor’s degree or equivalent work experience
• 🏥 3+ years of experience in medical collections, appeals, or denials
• 📚 Strong knowledge of healthcare billing, CPT/ICD-10, insurance terminology, and denial codes
• 🧩 Familiarity with HMO, PPO, IPO plans and coordination of benefits
• 🖊 Strong writing skills for crafting compelling appeals
• 🔎 Attention to detail, analytical mindset, and ability to multitask under pressure
• 🗣 Excellent communication, judgment, and customer service skills
• 💻 Proficiency in Microsoft Excel, Word, and healthcare systems
• ✅ Must pass a background and credit check due to financial duties
💼 Salary & Perks
💲 $22–$24/hour depending on experience and location
✅ Benefits include medical, dental, and 401(k)
💡 Play a key role in optimizing revenue for healthcare organizations
✨ Why Join Us?
• 🧠 Use your insurance knowledge to solve high-stakes payment puzzles
• 💥 Make a measurable impact on the bottom line
• 🧘 Enjoy full remote flexibility while contributing to a tight-knit virtual team
📲 Ready to appeal for the job you deserve?
Apply now and be the closer that gets claims paid.
~ 2 Chicks