Remote Denials & Appeals Specialist, Revenue Cycle

Firstsource Solutions Ltd; United States; Remote; USD 65.000 - 90.000; Vollzeit

Benefits dieser Stelle

Medical insurance

Vision insurance

Dental insurance

401K

Paid Time Off

Zusammenfassung

Firstsource Solutions Ltd seeks a Revenue Cycle Denials Representative to manage and resolve denied PB/HB claims. You will identify root causes, perform appeals, and collaborate with internal teams to prevent future denials.

Experience with CARC/RARC, Epic denial queues, and payer-specific guidelines is essential. Remote work is available with national scope; position requires 2+ years in denial management across PB (CMS-1500) and HB (UB-04) claims, and strong knowledge of payer requirements.

Qualifikationen

• High school diploma or equivalent required.
• Associate or Bachelor’s in Health Information Management or related field preferred.
• CPC/CPMA/CRCR/CHFP certification a plus.

Aufgaben

• Review denied PB/HB claims to determine root causes and resolution strategies.
• Analyze Epic history prior to actions to resolve claims.
• Work denials across No Authorization, Timely Filing, COB, Medical Necessity, ADR, Bundling, Duplicates.
• Interpret CARC/RARC codes on 835 remittance to determine resolution.
• Prepare and submit payer appeals with supporting documentation.
• Escalate when processing is inaccurate or delayed.

Ausbildung

High school diploma

Associate or Bachelor’s degree in Health Information Management, Business, or related field

CPC, CPMA, CRCR, or CHFP certification

Tools

Epic denial modules

Availity

Medicare.gov portals

Arkansas DHS portals

EOB/ERA 835 review

Jobbeschreibung

Firstsource Solutions Ltd seeks a Revenue Cycle Denials Representative to manage and resolve denied PB/HB claims. You will identify root causes, perform appeals, and collaborate with internal teams to prevent future denials.

Experience with CARC/RARC, Epic denial queues, and payer-specific guidelines is essential. Remote work is available with national scope; position requires 2+ years in denial management across PB (CMS-1500) and HB (UB-04) claims, and strong knowledge of payer requirements.