Help ensure patients receive the care they deserve by resolving complex insurance denials. As a Denial Management Specialist, you’ll research, appeal, and resolve payer denials to maximize reimbursement and improve financial outcomes for patients and providers.
About the Role
The Denial Management Specialist works within the Revenue Cycle team to investigate and resolve denials from Medicare, Medicaid, and commercial payers. You’ll manage appeals, write compelling arguments, and collaborate with internal teams, physicians, and payers to ensure timely reimbursement and compliance.
Schedule
- Fully remote, based in California
- Full-time role with performance standards tied to productivity and quality
What You’ll Do
- Research and resolve complex insurance claim denials related to authorizations, referrals, notifications, and medical necessity
- Write and submit detailed appeals using clinical documentation, payer policies, and contract language
- Track recovery efforts and identify payer-specific issues or trends
- Ensure all eligible accounts are appealed within payer timeframes
- Collaborate with insurance companies, patients, providers, and internal departments to resolve denials
- Review daily payer correspondence and take proactive action
- Maintain confidentiality and compliance with HIPAA and federal/state regulations
What You Need
- Bachelor’s degree or equivalent experience
- 3+ years of experience in medical collections, denials, appeals, and insurance follow-up
- Strong knowledge of CPT/ICD-10 codes and healthcare terminology
- Solid understanding of insurance plans (HMO, PPO, Medicare, Medicaid, commercial payers)
- Proficiency with payer portals such as Availity, NaviNet, etc.
- Strong writing and communication skills for professional appeals and payer correspondence
- Ability to analyze EOBs, remittance codes, and reimbursement requirements
- Proficiency with Microsoft Excel and Word
- Must pass a background and credit check
Compensation & Benefits
- Estimated pay: $22–$24 per hour (based on skills, location, and experience)
- Benefits package includes: medical, dental, and 401(k) retirement plan
If you have a sharp eye for detail, strong analytical skills, and a passion for navigating complex insurance processes, this remote role offers the chance to make a direct impact on patient access and financial outcomes.
Happy Hunting,
~Two Chicks…