Denials Specialist at Jobgether – United States
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About This Position
This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Denials Specialist in the United States.
This role is focused on improving revenue cycle outcomes by managing and resolving complex healthcare claim denials. You will work at the intersection of clinical documentation, payer communication, and revenue integrity, ensuring that denied claims are properly analyzed, corrected, and appealed when appropriate. The position requires strong attention to detail and a solid understanding of healthcare billing processes, as you investigate denial root causes and coordinate with insurers and providers. You will also prepare and submit appeals, often requiring medical record review and accurate claim resubmission. Working in a fast-paced healthcare environment, you will help ensure timely reimbursement and reduce revenue leakage for provider organizations. This is a remote role with occasional onsite flexibility depending on business needs.
- Analyze denied claims, remittance advice, and denial communications to identify root causes and determine appropriate resolution paths.
- Contact insurance payers to clarify denial reasons and validate claim status or requirements for appeal.
- Prepare and submit appeals, including claim corrections, resubmissions, and supporting documentation such as medical records.
- Collaborate with healthcare providers to obtain additional clinical documentation or clarification when needed.
- Act as a liaison between internal teams, providers, and payers to ensure timely and accurate resolution of denials.
- Apply revenue cycle knowledge to triage denials effectively and determine the most appropriate follow-up actions.
- Maintain accurate documentation and ensure compliance with quality and productivity standards in all appeal activities.
Requirements:
- 1–3 years of relevant experience in healthcare denials management or accounts receivable.
- Associate degree or equivalent professional experience in healthcare, finance, or related field.
- Strong understanding of revenue cycle processes and healthcare billing terminology.
- Experience in hospital operations, claims review, chart auditing, or provider relations is highly valued.
- Ability to interpret denial letters, payer responses, and remittance advice accurately.
- Strong written communication skills with ability to draft and format appeal letters efficiently (minimum typing speed of 35 WPM).
- Detail-oriented, inquisitive mindset with strong problem-solving and analytical skills.
- Comfortable working in a remote environment with occasional travel and onsite requirements.
- Openness to process improvement and use of innovative tools, including AI-assisted workflows.
Benefits:
- Hourly compensation ranging from $16.50 to $21.35 based on experience.
- Performance incentives, bonus programs, and recognition awards.
- Comprehensive healthcare, retirement, and well-being benefits.
- Tuition reimbursement and paid certification programs.
- Career advancement opportunities in a fast-growing healthcare organization.
- Remote work flexibility with occasional travel as needed.
- Strong culture focused on innovation, collaboration, and continuous improvement.
- Employee support programs promoting work-life balance and personal development.