FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Denial Resolution Specialist
Western Missouri Medical Center. Review denied claims in MEDITECH denial work queues: DEN-ELIG-*, DEN-AUTH-*, DEN-CODING-*, DEN-MEDNEC-*, DEN-TIMELY-* .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare billing and revenue cycle management, with a strong focus on denial management, appeals processes, and compliance with payer-specific policies. Proficient in analyzing EOBs and ERAs while maintaining high accuracy and productivity under tight deadlines.
Highest-signal resume keywords
Healthcare Billing ExperienceDenial Management ExpertiseEOB/ERA InterpretationMEDITECH ProficiencyAnalytical Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims CorrectionClaims ResubmissionPayer Code AnalysisDocumentation ReviewAppeal SubmissionSLA ComplianceDenial Code UnderstandingRevenue Cycle ManagementInsurance Billing KnowledgeProblem-Solving
Soft Skills
Attention to DetailEffective CommunicationNegotiation SkillsCritical ThinkingTime Management
Tools & Technologies
MEDITECHEHR SystemsClearinghouse Software
Industry Keywords
CMS GuidelinesPayer ContractsDenial CodesRevenue CycleHealthcare Compliance
About the role
Key responsibilities & impact- Review denied claims in MEDITECH denial work queues: DEN-ELIG-*, DEN-AUTH-*, DEN-CODING-*, DEN-MEDNEC-*, DEN-TIMELY-*
- Analyze Explanation of Benefits (EOB), Electronic Remittance Advice (ERA), and payer codes (CARC/RARC)
- Correct and resubmit claims
- Submit reconsiderations and formal appeals
- Request additional documentation
- Ensure denials are worked within established SLA, typically ≤5 days
- Prepare and submit first-level and second-level appeals
- Gather and review medical records, coding documentation, and authorization details
- Track appeal status through resolution
- Escalate complex or high-dollar cases as needed
- Maintain assigned denial queues by working accounts daily, meeting productivity targets, and preventing backlog accumulation
- Prioritize high-dollar claims, timely filing deadlines, and aging denials
- Contact insurance companies to clarify denial reasons, request reconsideration, and verify appeal requirements
- Maintain knowledge of payer-specific policies and updates
- Accurately document all actions taken on accounts
- Ensure compliance with CMS guidelines, payer contracts and requirements, and organizational policies
- Maintain regular and predictable attendance
- Perform other essential duties as assigned
Requirements
What you’ll need- High school diploma or equivalent required
- Current residency in the state of Kansas or Missouri is required
- 3+ years of healthcare billing or revenue cycle experience
- Experience working in an EHR system (MEDITECH preferred)
- Experience working in clearinghouse (SSI Preferred)
- Strong understanding of insurance billing and claims lifecycle
- Strong understanding of EOB/ERA interpretation
- Strong understanding of payer rules and denial codes
- Prior experience in denial management or appeals
- Analytical and critical thinking skills
- Strong attention to detail
- Problem-solving and root cause identification
- Effective communication and negotiation skills
- Ability to manage high volumes and deadlines
- Must be able to sit and stand, intermittent 8 to 10 hours a day
- Must be able to use standard office equipment, including the telephone and computer keyboard
- Ability to work under pressure of near 100% accuracy while meeting inflexible deadlines
- Ability to lift or carry up to 40 lbs occasionally
Benefits
Comp & perks- Full-time employment