{"schemaVersion":"jobsearcher.job.v1","id":"45c036231fd7a60acb2a50bf","url":"https://jobsearcher.com/jobs/45c036231fd7a60acb2a50bf","canonicalUrl":"https://jobsearcher.com/jobs/45c036231fd7a60acb2a50bf","title":"Denials Specialist - Remote","description":"1. About Our Client:The organization operates within the healthcare industry, supporting hospitals and healthcare providers in managing financial and clinical performance. It addresses challenges related to transitioning from volume-based to value-based care, improving patient experience, and optimizing healthcare quality, cost, and access. The organization provides services across more than 135 local regions nationwide, leveraging three decades of healthcare industry expertise to assist healthcare clients in strengthening their operations and community service.2. About the Opportunity:The Denials Specialist is responsible for managing the validation and appeal process for denied or underpaid healthcare claims. This role ensures accurate identification of denial reasons, coordinates necessary consultations, and generates appeals based on payer-specific contract terms. The position plays a key role in resolving payment discrepancies, escalating unresolved issues, and supporting payer-related projects, directly contributing to the organization’s financial accuracy and efficiency.3. Responsibilities:• Validate denial reasons and ensure accurate coding in the denial management system• Coordinate with clinical resources for consultations or referrals as needed• Generate appeals based on dispute reasons and payer contract terms, including online reconsiderations• Follow payer-specific guidelines for submitting appeals• Escalate appeals that have been exhausted for further resolution• Participate in payer projects as assigned• Research contract terms and compile documentation for appeals and overpayment referrals• Determine corrective actions and update the denial management system accordingly• Escalate denial or payment variance trends to leadership for further payor escalation4. Requirements:• Intermediate knowledge of Explanation of Benefits (EOB), managed care contracts, and federal/state requirements• Intermediate understanding of hospital billing forms (UB-04)• Familiarity with ICD-9, HCPCS/CPT coding, and medical terminology at an intermediate level• Intermediate skills in Microsoft Word and Excel• Advanced business letter writing skills, including grammar and punctuation• High school diploma or equivalent; some college coursework preferred• 3 to 5 years of experience in hospital billing or collections5. Pay Range and Compensation Package:• Pay: $18.60 to $28.00 per hour, depending on location, qualifications, and experience• Position may be eligible for a signing bonus for qualified new hires, subject to employment status• Time and a half pay for observed holidays6. Benefits & Perks:• Medical, dental, vision, disability, and life insurance• Paid time off with a minimum of 12 days per year, accruing at approximately 1.84 hours per 40 hours worked• 401k with up to 6% employer match• 10 paid holidays annually• Health savings accounts, healthcare and dependent flexible spending accounts• Employee assistance and discount programs• Voluntary benefits including pet, legal, accident, critical illness, long-term care, elder and childcare insurance, AD&D, and auto and home insurance• Paid leave for Colorado employees in accordance with the state’s Healthy Families and Workplaces ActEqual Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.Note:RemoteHunter is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS.","company":"Remotehunter","rawCompany":"remotehunter","isRemote":true,"isActive":false,"createdAt":"2026-05-17T19:10:33.158Z","occupations":[{"code":"29-2072.00","title":"Medical Records Specialists","slug":"medical-records-specialists"},{"code":"29-9021.00","title":"Health Information Technologists and Medical Registrars","slug":"health-information-technologists-and-medical-registrars"},{"code":"29-2099.08","title":"Patient Representatives","slug":"patient-representatives"}],"industries":[{"code":"621999","title":"All Other Miscellaneous Ambulatory Health Care Services","slug":"all-other-miscellaneous-ambulatory-health-care-services"},{"code":"621498","title":"All Other Outpatient Care Centers","slug":"all-other-outpatient-care-centers"},{"code":"621111","title":"Offices of Physicians (except Mental Health Specialists)","slug":"offices-of-physicians-except-mental-health-specialists"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Denials Specialist - Remote","description":"1. About Our Client:The organization operates within the healthcare industry, supporting hospitals and healthcare providers in managing financial and clinical performance. It addresses challenges related to transitioning from volume-based to value-based care, improving patient experience, and optimizing healthcare quality, cost, and access. The organization provides services across more than 135 local regions nationwide, leveraging three decades of healthcare industry expertise to assist healthcare clients in strengthening their operations and community service.2. About the Opportunity:The Denials Specialist is responsible for managing the validation and appeal process for denied or underpaid healthcare claims. This role ensures accurate identification of denial reasons, coordinates necessary consultations, and generates appeals based on payer-specific contract terms. The position plays a key role in resolving payment discrepancies, escalating unresolved issues, and supporting payer-related projects, directly contributing to the organization’s financial accuracy and efficiency.3. Responsibilities:• Validate denial reasons and ensure accurate coding in the denial management system• Coordinate with clinical resources for consultations or referrals as needed• Generate appeals based on dispute reasons and payer contract terms, including online reconsiderations• Follow payer-specific guidelines for submitting appeals• Escalate appeals that have been exhausted for further resolution• Participate in payer projects as assigned• Research contract terms and compile documentation for appeals and overpayment referrals• Determine corrective actions and update the denial management system accordingly• Escalate denial or payment variance trends to leadership for further payor escalation4. Requirements:• Intermediate knowledge of Explanation of Benefits (EOB), managed care contracts, and federal/state requirements• Intermediate understanding of hospital billing forms (UB-04)• Familiarity with ICD-9, HCPCS/CPT coding, and medical terminology at an intermediate level• Intermediate skills in Microsoft Word and Excel• Advanced business letter writing skills, including grammar and punctuation• High school diploma or equivalent; some college coursework preferred• 3 to 5 years of experience in hospital billing or collections5. Pay Range and Compensation Package:• Pay: $18.60 to $28.00 per hour, depending on location, qualifications, and experience• Position may be eligible for a signing bonus for qualified new hires, subject to employment status• Time and a half pay for observed holidays6. Benefits & Perks:• Medical, dental, vision, disability, and life insurance• Paid time off with a minimum of 12 days per year, accruing at approximately 1.84 hours per 40 hours worked• 401k with up to 6% employer match• 10 paid holidays annually• Health savings accounts, healthcare and dependent flexible spending accounts• Employee assistance and discount programs• Voluntary benefits including pet, legal, accident, critical illness, long-term care, elder and childcare insurance, AD&D, and auto and home insurance• Paid leave for Colorado employees in accordance with the state’s Healthy Families and Workplaces ActEqual Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.Note:RemoteHunter is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS.","datePosted":"2026-05-17T19:10:33.158Z","dateModified":"2026-05-17T19:10:33.158Z","hiringOrganization":{"@type":"Organization","name":"Remotehunter","sameAs":"https://jobsearcher.com"},"jobLocationType":"TELECOMMUTE","applicantLocationRequirements":{"@type":"Country","name":"US"},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"45c036231fd7a60acb2a50bf"},"url":"https://jobsearcher.com/jobs/45c036231fd7a60acb2a50bf"}}