Denials & Appeals Specialist (Hybrid/Remote)

Brown University Health; Providence (RI); Hybrid; USD 32,000 - 53,000; Full time

Benefits offered by this job

Telecommuting options

Flexible schedules

Job summary

Brown University Health is seeking a Denials Management Specialist in Rhode Island. The role focuses on maximizing reimbursement by analyzing denials, tracking trends, and supporting strategic initiatives related to denials reduction.

You will handle appeals with third-party payers, coordinate with hospital departments, and ensure timely resolution of issues. Experience in hospital patient accounting and knowledge of ICD-9/10, CPT-4, UB-04, HCFA 1500 is required.

Qualifications

• Associate degree or equivalent experience in accounting or related field.
• 3–5 years experience in hospital patient accounting.
• Knowledge of ICD-9/10, CPT-4, UB04 and HCFA 1500 claims.
• Ability to perform financial analysis.

Responsibilities

• Evaluate denied accounts and assign to appropriate work queues for resolution.
• Review denial databases to categorize provider liable denials, root causes, and resolutions.
• Track appeals and ensure timelines are met; prepare reports for denial trends.
• Develop relationships with hospital departments and physicians to obtain information for successful appeals.

Skills

Financial analysis

Claims processing

Denials management

ICD coding

Education

Associate’s degree in accounting

Tools

Microsoft Teams

Job description

Brown University Health is seeking a Denials Management Specialist in Rhode Island. The role focuses on maximizing reimbursement by analyzing denials, tracking trends, and supporting strategic initiatives related to denials reduction.

You will handle appeals with third-party payers, coordinate with hospital departments, and ensure timely resolution of issues. Experience in hospital patient accounting and knowledge of ICD-9/10, CPT-4, UB-04, HCFA 1500 is required.