Revenue Cycle Denial Specialist

This is a fully remote position, open to applicants in Arizona, +9 more states.

📋 Description

• Evaluate, investigate, and address post-billed denials and rejections related to hospital and professional claims.

• Prepare and oversee appeals within specified timelines.

• Work collaboratively across various departments to minimize avoidable denials.

• Deliver reporting and training to enhance system-wide revenue cycle performance.

• Assist denial-related committees and task forces through comprehensive reporting, analysis, and coordination.

• Handle audit requests, ensuring timely submission and tracking of documentation.

• Stay updated on payer regulations, state and federal laws, and reimbursement policies.

⛳️ Requirements

• Associate's degree or Certification in Healthcare Business, or a related field, or an equivalent combination of education and experience may be accepted.

• A minimum of three (3) years of healthcare experience in a revenue cycle role.

• Three (3) years of experience with International Classification of Diseases, Tenth Revision (ICD-10) diagnosis and procedure coding, Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS).

• Proficient in Microsoft Office applications, with advanced skills in Excel, Word, and PowerPoint.

• Preferred certifications include Healthcare Financial Management Association Revenue Cycle Representative (HFMA CRCR) or Certified Professional Coder (CPC).

• Five (5) years of experience in a hospital revenue cycle billing role.

• Familiarity with Epic or other electronic medical record (EMR) systems.

• Experience utilizing payer portals, electronic work queues, and tools for tracking denials and appeals.

🏝️ Benefits

• Regular and consistent attendance is mandatory.

• On-call duties may be necessary.

• Completion of educational requirements as assigned per DNV standards, Bozeman Health policy, and registry obligations.