Complex Denials Consultant jobs in United States
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R1 RCM ยท 7 hours ago

Complex Denials Consultant

positionUnited States
timeFull-time
remoteRemote
seniorityMid Level
money$81K/yr - $113K/yr

R1 RCM is the leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare organizations. As a Complex Denials Consultant, you will represent healthcare providers in disputes with insurance carriers and managed care organizations, handling contract reviews and developing appeals to resolve denials.

Health CareHospitalInformation TechnologyInfrastructureMedical

Responsibilities

Assist recovery staff in pursuing appeals, including the development of new and innovative legal and procedural arguments and tools
Draft complex and contractual appeals and letters to insurance companies
Review and apply client contract language and rates to resolve denied claims
Utilize payer-provider and administrative manuals to dispute denied claims
Contact provider representatives or higher-level resolution units to resolve complex claim and appeal issues
Represent clients during Administrative Law Judge hearings as needed
Assist with the training of recovery staff team members and provide necessary feedback as requested by management
Apply provider-specific reimbursement methodologies, payment policies, and provider contracts to fully confirm payment

Qualification

Law degreeBar eligibilityContract reviewAppeal writingHealthcare regulationsCommunication skillsTeam collaboration

Required

Law degree from an accredited college or university
Barred in one state or must be bar-eligible within 6 months of graduation

Benefits

Annual bonus plan at a target of 10.00%
Competitive benefits package

Company

R1 RCM

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R1 RCM serves as a revenue cycle management partner for hospitals and healthcare systems regardless of the payment models.
dateFounded in 2003
location
Chicago, Illinois, USA
people-size10001+ employees
web-link
http://www.r1rcm.com/

Funding

Current Stage
Public Company
Total Funding
$200M
Key Investors
Khosla VenturesIntermountain Healthcare
2025-05-28Private Equity
2024-08-01Private Equity
2024-08-01Acquired

Leadership Team

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Joseph Flanagan
CEO
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Estelle Barnes
EVP, Enterprise Customer Engagement
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Recent News

PharmiWeb
Healthcare Revenue Cycle Management Market
2026-01-07
GlobeNewswire
Medical Billing Outsourcing Market Size to Hit USD 40.43 Billion by 2033, Growing at a CAGR of 12.65% - SNS Insider
2026-01-07
Columbia West
Utah Deal Intelligence - October 2025
2025-12-13
Company data provided by crunchbase