Denial Management Specialist (Remote)

Overview

LEARN Behavioral is a national organization made up of dedicated and caring individuals with the sole purpose of nurturing children with autism and special needs to lead resilient and fulfilling lives.  We specialize in contemporary, evidence based applied behavior analysis to deliver personalized treatment plans, backed by 20 years of clinical insights.  We are proud to be a part of each family’s journey and share in the experience of finding success for every child, and family, in our care.  If you share a similar passion for nurturing and empowering the success of others, along

 

The Denial Management Specialist provides leadership and training within the RCM Department, under the direction of the RCM Manager. The successful candidate will have excellent attention to detail, have the highest standard of customer service, excellent written, verbal communications skills, and be proficient in revenue cycle management.

 

This is a full-time remote opportunity. Open to candidates who reside in any time zone. Salary starting at $75,000/annually.

Responsibilities

• Investigate, resolve, and appeal denied or underpaid insurance claims
• Analyze denial trends and payer behavior
• Maintain accurate documentation and follow-up activities
• Partner with Revenue Cycle, Utilization Management, Credentialing, Clinical, and Operations teams
• Monitor assigned denial work queues and productivity metrics t
• Assist the RCM Department in leadership coaching, oversight, support, and training for Revenue Cycle Management team members, as needed.
• Working closely with payers and operation leads to troubleshoot and resolve claims.
• Continuously provide improvements to systems and processes along with support to team members within the RCM Department.
• Effectively communicate with our payors’ partners and Operation Leads.
• Navigate claims appeals and special projects with payors.
• Review all unbilled claims and outstanding A/R.
• Prioritize meeting department deadlines.
• Process audit requests timely and accurately.
• Take the lead on monitoring assigned projects to completion. 

Qualifications

• High School diploma required; Bachelor’s Degree in Finance, Accounting, Healthcare Administration, or related field preferred.
• 5+ years in revenue cycle management, with at least 1 year in a supervisory or team lead role required
• Experience in Billing Software, Clearinghouse, Payor Portals, and Excel required 
• Strong analytical and strategic thinking skills

• Excellent communication and interpersonal skills

• Ability to Identify complex problems and reviewing related information to develop and evaluate options and implement solutions.

• Demonstrated ability to work independently and as part of a team in a fast-paced, dynamic environment.

• Strong organizational skills and attention to detail, with the ability to manage multiple priorities and deadlines effectively.

LEARN Behavioral offers competitive compensation, a comprehensive benefits plan, including 401(k), personal time off, paid holidays, and tuition reimbursement.

 

LEARN Behavioral is an Equal Opportunity Employer. Candidates must be presently eligible to work in the United States.