Hybrid Denials Specialist – Payer Appeals

Children's Hospital Colorado; Aurora (CO); Hybrid; USD 33,000 - 50,000; Full time

Benefits offered by this job

Competitive pay

Incentives

Paid time off

Medical/dental/vision insurance

Life and disability insurance

Parental leave

403b employer match

Wellness program

Education benefit

Professional development tools

Job summary

Children's Hospital Colorado is seeking a Denials Specialist in Aurora to support denials management within Patient Financial Services. The role requires analyzing denials, performing root-cause analyses across departments, and working with payers to secure payments due.

The position is full-time, 40 hours weekly, with a day shift from Monday to Friday in a hybrid work model. Strong collaboration with PFS, ambulatory services, case management, and HIM is essential for success.

Qualifications

• High School diploma or GED required.
• Minimum 3 years healthcare or revenue cycle experience.

Responsibilities

• Writes and sends detailed reconsiderations and/or appeals for denials to payers; handles large volumes with quality.
• Acts as escalation point to review and resolve escalated accounts and denial issues with internal teams.
• Identifies gaps in payment/reasoning or system errors and takes steps to resolve.
• Drafts appeals for payer audits and supports audits as needed.
• Conducts root cause analyses for different account types to solve recurring issues.
• Reviews contracts, summaries, and payer policies to apply correct account treatment.

Skills

Denials management

Root-cause analysis

Communication

Education

High School diploma or GED

Tools

EMR systems

Payer portals

Job description

Children's Hospital Colorado is seeking a Denials Specialist in Aurora to support denials management within Patient Financial Services. The role requires analyzing denials, performing root-cause analyses across departments, and working with payers to secure payments due.

The position is full-time, 40 hours weekly, with a day shift from Monday to Friday in a hybrid work model. Strong collaboration with PFS, ambulatory services, case management, and HIM is essential for success.