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Abound Health · 2 weeks ago

Denial Management Specialist

United States

Full-time

Remote

Senior Level

5+ years exp

Abound Health is seeking a Denial Management Specialist to join their Revenue Cycle Management team in a remote capacity. This role involves analyzing, tracking, and resolving claim denials to ensure timely reimbursement and compliance with payer requirements, while collaborating with internal teams and external payers.

Health CareNon ProfitSoftware

Responsibilities

Review and analyze denied claims to identify root causes and resolution steps

Collaborate with revenue cycle and clinical teams to correct errors and resubmit claims

Communicate with payers to clarify denial reasons and submit appeals as appropriate

Track denial trends, appeal status, and outcomes with accurate documentation

Develop strategies to reduce denial rates and improve first-pass claim acceptance

Prepare reports on denial metrics, financial impact, and corrective actions for leadership

Monitor compliance with payer guidelines, Medicaid regulations, and internal policies

Qualification

Denial managementHealthcare billingRevenue cycle operationsAnalytical skillsEHR systemsMS OfficeMedicaid knowledgeCommunication skillsCollaboration skillsAttention to detail