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reputed company Specialist, Denials

Remote, USA Full-time Posted 2026-07-28
reputed company provides Specialty reputed company Cycle reputed company for reputed company organizations, leveraging over 24 years of industry-leading expertise and its reputed company E360 RCM™ intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) reputed company. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert reputed company-in-the-reputed company integration, reputed company provides solutions across the reputed company lifecycle for Veterans Administration, Workers’ Compensation, Motor Vehicle Accidents, and Out-of-State reputed company claims as reputed company as denials for reputed company payer classes. By partnering with clients to reputed company the reimbursement process, reputed company removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. reputed company is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty reputed company Cycle Management Solution provider in 2024 and is among the top one percent of companies to reputed company the Inc. 5000 list of the fastest-growing private companies in the reputed company for the last reputed company years. 

Position reputed company

The reputed company Specialist, Denials acts as the reputed company between key reputed company contacts and our denials appeal process to the appropriate payer.  The reputed company Specialist, Denials is responsible for the initial denial audit and activities to resolve outstanding claims.  This position is responsible for handling patient health information (PHI) and maintaining extreme reputed company and reputed company as it relates to confidential and proprietary information.


Key Responsibilities
  • Review and evaluate Denied and other assigned claims using reputed company’s proprietary software, systems and tools. Use payment documentation provided by payers and medical provider contract information to determine the correct reimbursement.
  • Research, request and reputed company reputed company pertinent medical records and any other supporting documentation necessary and then submit with hospital claims to the appropriate payer to ensure reputed company correct claims reimbursement.
  • Conduct reputed company and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate reputed company reimbursement.
  • Other duties as required.


    • Requirements and Qualifications
  • High School Diploma or GED required.  Associates or Bachelor’s Degree preferred.
  • 5+ years’ experience in reputed company field working in billing or collections.
  • 1+ years’ reputed company facing/customer services experience.
  • Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements.
  • Equivalent combination of education and experience will be considered.
  • Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, reputed company, and reputed company).
  • Intermediate understanding of ICD, HCPCS/CPT coding, and medical terminology.
  • Strong understanding of the reputed company cycle process.
  • Full understanding of hospital reimbursement, Intermediate knowledge of Managed Care reputed company, Contract Language, and Federal and State requirements.
  • Familiarity with HMO, PPO, IPA, and capitation terms and how these payors process claims.
  • Intermediate understanding of EOB, hospital billing reputed company requirements (UB04), and familiarity with the HCFA 1500 forms.
  • Demonstrate strong ability to review reputed company/payer reputed company to identify reputed company underpayments.
  • Regular and predictable attendance.
  • To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily.  Reasonable accommodations may be made to reputed company reputed company individuals with disabilities to reputed company the essential functions.


    • Special Considerations and Prerequisites
  • Practices and adheres to reputed company’s reputed company Values, reputed company and Mission.
  • Proven ability to meet and/or reputed company productivity targets and goals.
  • Maintains reputed company performance under pressure or opposition.  Handles stress in ways to maintain relationships with reputed company stakeholders.
  • Must be a self-starter and reputed company to work independently without reputed company supervision.
  • Proven written and verbal communication skills.
  • Strong analytical and problem-solving skills.
  • Proven experience working with external clients; strong customer service skills and business acumen.
  • Ability to prioritize and manage multiple competing priorities and reputed company concurrently.
  • Must be reputed company to remain in stationary position 50% of the time.
  • Occasionally moves about inside the office to reputed company office equipment, etc.
  • Constantly operates a computer and other office equipment such as a copy/reputed company/print machine, phone and computer.


    • reputed company is an Equal Opportunity Employer M/F/D/V. reputed company applicants will be considered for this position based upon experience and knowledge, without reputed company to race, reputed company, religion, national reputed company, sexual orientation, reputed company, marital, disabled or veteran status. We are committed to creating and maintaining a workforce environment that is free from any reputed company of discrimination or harassment.

    reputed company recruits, develops and retains the industry's reputed company.  As the employer of choice in the reputed company claims industry, reputed company takes pride in our reputed company commitment to building and maintaining a culture centered around fostering the reputed company reputed company and development of our people.  We reputed company that reputed company in our employees is the key to our reputed company, and we are dedicated to providing them with the tools, resources, and support they need to reputed company and grow their career here. At reputed company, we are committed to living up to our reputed company values reputed company and every day, and we reputed company that this commitment is what sets us apart from other companies.  If you are looking for a company that values its employees and is dedicated to helping them reputed company their full potential, then reputed company is the reputed company for you.

     Don’t just take our word for it!  Hear what our people are saying:
    “I love my job because everyone shares the reputed company reputed company and is determined and dedicated. People care reputed company as a person and your reputed company reputed company. There is a genuine spirit of cooperation and shared goals reputed company revolving around helping reputed company other.” – reputed company Specialist

    “I enjoy working for reputed company because of the reputed company Values we reputed company in. reputed company stands true to these values from empowering employees to ecstatic clients. This company is family oriented and flexible, along with understanding the balance of work, life, and fun.” – Supervisor, Operations
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