AR Denials Resolution Expert

Healthrise; United States; On-site; USD 45,000 - 75,000; Full time

Job summary

Healthrise is seeking a Denials Resolution Specialist to support the Hospital and Medical Group revenue operations. The role focuses on post-billed denials, root-cause analysis, and timely recovery of under- or overpayments across commercial and government payers.

Responsibilities include researching denials, coordinating with clinical teams, and documenting actions while ensuring compliance with state and federal regulations. Strong communication and attention to detail are essential.

Qualifications

• High school diploma or Associate degree in Accounting, Business Administration, or related field; 2–3 years in revenue cycle medical billing and denial management.
• Experience in hospital/clinic or health insurance settings preferred; California payer compliance knowledge beneficial.
• Excellent written and verbal communication and organizational skills.

Responsibilities

• Reviews, researches, and resolves payment delays and variances on denied claims.
• Processes payments in accordance with contracts to ensure timely resolution.
• Investigates root causes of denials and collaborates with clinical/coding teams for resolution.
• Maintains knowledge of state and federal laws related to appeals and denials.
• Documents actions in patient accounting system and prepares trend reports.

Skills

Attention to detail

Communication skills

Organizational skills

Customer service

Independent work

Time management

Education

Associate degree in Accounting, Business Administration, or related field

High school diploma

Tools

Epic

Microsoft Excel

Microsoft Word

Microsoft PowerPoint

Job description

Healthrise is seeking a Denials Resolution Specialist to support the Hospital and Medical Group revenue operations. The role focuses on post-billed denials, root-cause analysis, and timely recovery of under- or overpayments across commercial and government payers.

Responsibilities include researching denials, coordinating with clinical teams, and documenting actions while ensuring compliance with state and federal regulations. Strong communication and attention to detail are essential.