Denials & Appeals Specialist (Revenue Cycle)

Healthrise; Farmington Hills (MI); On-site; USD 60,000 - 80,000; Full time

Job summary

Healthrise is looking for a Clinical Denial Specialist in Farmington Hills, Michigan. This role is vital for ensuring accurate reimbursement for healthcare services by reviewing denied claims and appealing them effectively. You will analyze denial reasons, collaborate with healthcare providers, and improve revenue cycle processes.

A Bachelor's degree in healthcare administration or nursing is required, along with 2–3 years of experience in revenue cycle management. Strong analytical and communication skills are essential for success.

Qualifications

• Bachelor's degree in healthcare administration, nursing, or related field.
• Minimum of 2–3 years experience in healthcare revenue cycle management.
• Strong understanding of medical billing and claims processing.

Responsibilities

• Analyze denial reasons to identify opportunities for process improvement.
• Collaborate with healthcare providers to gather necessary documentation.
• Document appeal activities and monitor denial trends.

Skills

Analytical thinking

Communication skills

Attention to detail

Problem-solving

Understanding of medical terminology

Education

Bachelor's degree in healthcare administration or related field

RN credentials (denials/CDI)

Job description

Healthrise is looking for a Clinical Denial Specialist in Farmington Hills, Michigan. This role is vital for ensuring accurate reimbursement for healthcare services by reviewing denied claims and appealing them effectively. You will analyze denial reasons, collaborate with healthcare providers, and improve revenue cycle processes.

A Bachelor's degree in healthcare administration or nursing is required, along with 2–3 years of experience in revenue cycle management. Strong analytical and communication skills are essential for success.