Role OverviewLead denials management and appeals operations, overseeing identification, categorization, and resolution of claim denials. Evaluate AI-generated appeal letters and denial root cause analyses for accuracy and effectiveness.
What You Will Do
Analyze denial trends, develop and manage clinical and technical appeal strategies, and monitor denial management KPIs. Ensure compliance with payer appeal requirements and CMS regulations.
Why It Might Be a Fit
Must have 5+ years of experience in denials management, appeals, or revenue cycle operations, with at least 2 years in a management role. Proficiency with EHR systems and billing platforms, and exceptional written and verbal English communication skills.
Requirements
- 5+ years of experience in denials management, appeals, or revenue cycle operations
- Deep knowledge of CARC/RARC denial codes, payer denial patterns, and appeal strategies
- Strong understanding of clinical and technical appeal processes
- Experience with denial analytics platforms and revenue cycle reporting tools
- Proficiency with EHR systems and billing platforms
- Exceptional written and verbal English communication skills
Benefits
- Hourly compensation of $70–$93
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