Epic Revenue Cycle Denials Specialist

AA2IT; Fort Worth (TX); On-site; USD 65,000 - 90,000; Full time

Job summary

AA2IT is seeking a Revenue Cycle Clinical Denials Specialist in Texas to manage complex clinical denials, perform root cause analysis, and file compelling appeals based on clinical documentation and payor policies.

The role requires Epic HB Resolute experience, strong analytical and communication skills, and the ability to track trends and drive process improvements in a hospital Revenue Cycle setting.

Qualifications

• Must have Epic Systems Revenue Cycle Solutions (HB Resolute) experience.
• Experience with clinical denials management and appeals.
• Knowledge of insurance billing principles and payor policies.
• Understanding of regulatory compliance in billing and coding.

Responsibilities

• Manage denial and appeal workload and communicate results to stakeholders.
• Perform root cause analysis on denials to identify trends.
• Draft and submit professional appeals based on clinical docs and policies.
• Monitor payor guidelines to ensure timely submission and resolution.
• Support audit/compliance activities and maintain key process documentation.

Skills

Clinical denials management

Appeals writing

Medical billing & coding

Payor contracts & policies

Regulatory compliance

Analytical reasoning

Communication skills

Team coordination

Education

High School/Equivalent

Tools

InterQual

Milliman Care Guidelines

Job description

AA2IT is seeking a Revenue Cycle Clinical Denials Specialist in Texas to manage complex clinical denials, perform root cause analysis, and file compelling appeals based on clinical documentation and payor policies.

The role requires Epic HB Resolute experience, strong analytical and communication skills, and the ability to track trends and drive process improvements in a hospital Revenue Cycle setting.