Medical Denials Specialist

TEKsystems; Atlanta (GA); Remote; USD 30,000 - 34,000; Full time

Job summary

TEKsystems is seeking a Denials Specialist to join our Revenue Cycle team. The role focuses on reviewing, researching, and resolving denied medical claims to ensure timely reimbursement in a remote setting.

The ideal candidate will have 6 months of denials experience, familiarity with Athenahealth, and strong Excel/Google Sheets skills to analyze denial trends and drive resolution. This is a contract role with remote work options.

Qualifications

• Minimum 6 months of denials management experience in a provider-based healthcare environment.
• Up to 3 years of denials and claims resolution experience preferred.
• Hands-on experience reviewing and resolving denied medical claims.
• Experience with Athenahealth (Athena) including denial review, worklists, and claim workflows.
• Proficiency with Microsoft Excel and Google Sheets (sorting, filtering, basic formulas, VLOOKUP, Pivot Tables).
• Strong problem-solving and communication skills.

Responsibilities

• Review denied claims via Athena worklists and payer portals.
• Analyze denial reasons and identify root causes (COB, eligibility, coding, deductibles).
• Correct, resubmit, and track denied claims for reimbursement.
• Monitor denial worklists, aging, and backlogs; analyze trends.
• Collaborate with Revenue Cycle teams to resolve issues and prevent denials.
• Use Excel/Google Sheets to organize and analyze denial data.
• Communicate with patients and payers when needed; support process improvements.

Skills

Denials management

Athenahealth experience

Excel

Google Sheets

Payer portals

Analytical thinking

Communication skills

Tools

Athenahealth

Microsoft Excel

Job description

Location: Remote

Pay Rate: $22.00 - $25.00/hour (based on experience)

Position Overview

We are seeking a detail-oriented and proactive Denials Specialist to join our Revenue Cycle team. In this role, you will be responsible for reviewing, researching, and resolving denied medical claims to ensure timely and accurate reimbursement. The ideal candidate has experience working in a provider-based healthcare environment, strong analytical skills, and the ability to independently investigate denial issues and drive claims to resolution.

This position requires a self-starter who is comfortable navigating multiple systems, working in a fast-paced environment, and collaborating with internal teams and payer representatives to resolve complex reimbursement challenges.

Key Responsibilities

• Review denied claims through Athena worklists, payer portals, and other revenue cycle systems.

• Analyze denial reasons and identify root causes, including:

• Coordination of Benefits (COB)

• Eligibility issues

• Coding discrepancies

• Deductible and coverage-related denials

• Authorization and billing errors

• Conduct research using internal systems, payer guidelines, and billing resources to determine appropriate corrective action.

• Collaborate with internal Revenue Cycle and Billing teams to resolve claim issues and prevent future denials.

• Correct, resubmit, and track denied claims to ensure accurate reimbursement.

• Monitor and maintain denial worklists, backlog inventories, and aging accounts.

• Utilize Excel and Google Sheets to organize, track, and analyze denial trends.

• Access payer portals to obtain denial reports, review claim status, submit corrections, and follow up on outstanding claims.

• Communicate professionally with patients, customers, and payer representatives when payer-side corrections are not applicable.

• Support process improvement initiatives and contribute to workflow optimization efforts.

• Assist with evolving revenue cycle processes as the organization continues to enhance Athena system utilization.

Required Qualifications

• Minimum 6 months of denials management experience in a provider-based healthcare environment.

• Up to 3 years of denials and claims resolution experience preferred.

• Hands-on experience reviewing and resolving denied medical claims.

• Ability to independently identify denial causes and determine appropriate corrective actions.

• Experience working within Athena (Athenahealth), including denial review, worklists, and claim workflows.

• Familiarity with payer portals for claim research, denial reporting, and claim resubmissions.

• Strong knowledge of healthcare claims processing and reimbursement practices.

• Proficiency with Microsoft Excel and Google Sheets, including:

• Sorting and filtering data

• Basic formulas and reporting functions

• Experience with VLOOKUPs and Pivot Tables preferred

• Comfortable working in a Mac-based environment with dual monitors.

• Excellent problem-solving and critical-thinking skills.

• Strong written and verbal communication skills.

• Ability to work independently, manage priorities, and meet deadlines with minimal supervision.

Preferred Qualifications

• Experience in Accounts Receivable (AR) and claims resolution.

• Medicaid billing and reimbursement experience.

• Data entry and record management experience.

• Familiarity with AI tools and technology solutions.

• Experience working with alternative or membership-based billing models.

• Process improvement and workflow development experience.

• Experience assisting with training documentation or operational procedures.

Ideal Candidate

• An independent problem solver who takes initiative and ownership of their work.

• Curious and analytical, with the ability to investigate issues thoroughly.

• Reliable, responsive, and accountable for meeting deadlines.

• Comfortable in a dynamic and evolving environment.

• Professional and confident when communicating with customers, payers, and internal stakeholders.

• Tech-savvy and adaptable to new systems and processes.

Compensation

• $22.00/hour: Candidates with 6 months to 1 year of denials experience.

• Up to $25.00/hour: Candidates with advanced denials experience (up to 3 years) and strong Athena, payer portal, and claims resolution expertise.

Job Type & Location

This is a Contract position based out of Atlanta, GA.

Pay and Benefits

The pay range for this position is $22.00 - $25.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Oct 15, 2026.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.