Remote Technical Denials & Appeals Specialist

St. Elizabeth HealthCare; Erlanger, Northern (KY, KY); Hybrid; USD 52,000 - 68,000; Full time

Job summary

St. Elizabeth Healthcare is seeking a Technical Denials Specialist. This role is remote after an initial training period and full-time dayshift.

The specialist analyzes, resolves and reports non-clinical denials to the Denials Unit Manager as appropriate and follows up on escalated denials in a work queue to drive timely resolutions. The position requires 3 years of related experience or an associate degree with CRCR certification, and strong comfort with payer communications and documentation.

Qualifications

• Associates degree required.
• Alternatively, High School Diploma with CRCR certification and 3 years related experience.
• Proficiency in Microsoft Office applications.
• Knowledge of Medicare and Medicaid regulations.
• Experience in customer service and payer communications.

Responsibilities

• Analyze and resolve non-clinical denials.
• Follow up on work queues and complete appeals.
• Communicate with payers to obtain documentation.
• Prepare documentation for payer appeals and joint calls.
• Ensure compliance with policies and HIPAA.

Skills

Customer service

Communication

Attention to detail

Education

Associates degree

High School Diploma + CRCR

Tools

Microsoft Office

Job description

St. Elizabeth Healthcare is seeking a Technical Denials Specialist. This role is remote after an initial training period and full-time dayshift.

The specialist analyzes, resolves and reports non-clinical denials to the Denials Unit Manager as appropriate and follows up on escalated denials in a work queue to drive timely resolutions. The position requires 3 years of related experience or an associate degree with CRCR certification, and strong comfort with payer communications and documentation.