Denial Resolution Specialist

Jobtailor; Kansas; On-site; USD 60,000 - 78,000; Full time

Job summary

Jobtailor is seeking a detail-oriented Revenue Cycle Specialist in the Kansas/Missouri area to manage denial resolution, appeals, and documentation accuracy. You will analyze EOBs/ERAs, correct and resubmit claims, and work with payers to ensure timely resolutions.

Ideal candidates have 3+ years in healthcare billing, MEDITECH experience, and strong negotiation and communication skills to support revenue recovery and denial prevention.

Qualifications

• 3+ years of healthcare billing or revenue cycle experience.
• Residency in Missouri or Kansas is required.
• Experience with MEDITECH preferred and SSI clearinghouse.
• Strong understanding of insurance billing and claims lifecycle; payer rules and denial codes.
• Prior experience in denial management or appeals.
• Analytical thinking, attention to detail, problem-solving and negotiation skills.
• Excellent written and verbal communication for negotiations and documentation.

Responsibilities

• Review denied claims in MEDITECH denial queues and correct/re-submit.
• Analyze EOBs, ERAs, and payer codes (CARC/RARC).
• Submit reconsiderations and formal appeals.
• Request additional documentation as needed to support appeals.
• Meet productivity targets and handle high-dollar denials with priority.

Skills

Denial management

EOB/ERA interpretation

Analytical thinking

Attention to detail

Negotiation skills

Effective communication

Prior experience in denial management

Education

High school diploma

Bachelor’s degree preferred

Tools

MEDITECH

Clearinghouse (SSI)

EHR system

Job description

• Review denied claims in MEDITECH denial work queues: DEN-ELIG-*, DEN-AUTH-*, DEN-CODING-*, DEN-MEDNEC-*, and 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
• Work denials within established service-level agreements, typically within 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
• Work assigned denial accounts daily
• Meet productivity targets and prevent 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 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
• Contribute to denial resolution, revenue recovery, denial prevention, and revenue cycle improvement

Requirements

• High school diploma or equivalent required
• Bachelor’s degree is preferred
• Residency in Missouri or Kansas 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
• Ability to sit and stand intermittently 8 to 10 hours a day
• Ability to use standard office equipment, including the telephone and computer keyboard
• Ability to work under pressure while meeting near-100% accuracy requirements and inflexible deadlines
• Manual/bi-manual dexterity, near vision, speech, and hearing
• Ability to lift or carry up to 40 lbs.
• Ability to occasionally walk on uneven surfaces

Core Competencies

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, and skilled in effective communication and problem-solving to resolve claims denials.

Highest-signal resume keywords

• Healthcare Billing Experience
• Denial Management
• EOB/ERA Interpretation
• MEDITECH Proficiency
• Analytical Skills

Hard Skills

• Claims Lifecycle Management
• Payer Rules Understanding
• Denial Codes Knowledge
• Revenue Cycle Improvement
• Documentation Accuracy

Soft Skills

• Attention to Detail
• Problem-Solving
• Effective Communication
• Negotiation Skills
• Critical Thinking

Industry Keywords

• CMS Guidelines
• Payer Contracts
• Revenue Recovery
• Denial Prevention
• Service-Level Agreements

Tools & Technologies

• EHR System
• MEDITECH
• Clearinghouse (SSI)