Revenue-Cycle Denials Specialist

Gritman Medical Center, Inc.; Moscow (ID); On-site; USD 65,000 - 90,000; Full time

Job summary

Gritman Medical Center, Inc. in Moscow, ID is seeking a Denials Management Specialist to join the Patient Accounting team on-site. You will analyze, prevent, and resolve claim denials across CAH, specialty clinics, and RHC settings using Epic revenue-cycle tools.

Responsibilities include managing denials and appeals, researching root causes, collaborating with clinical and billing staff, and developing corrective-action plans to improve clean-claim performance and timely reimbursement.

Qualifications

• Three years of progressively responsible experience in hospital revenue cycle, denials management, or related function.
• Experience with CAH, RHC, and/or specialty clinic operations preferred.
• Experience handling denials, corrections, reconsiderations, appeals, and timely filing.
• Knowledge of Medicare, Medicaid, commercial payer policies and denial processes.
• Hands-on use of Epic for denial management, research, workflow, and reporting.
• Proficiency in Excel (sorting, filtering, pivot tables) and MS Office.

Responsibilities

• Review and resolve denials, underpayments, and appeals in Epic within set work queues and deadlines.
• Research denial root causes using documentation, coding, and payer policies.
• Prepare, submit, and track corrected claims, reconsiderations, and appeals.
• Maintain complete denial activity documentation in Epic and other systems.
• Monitor denial volumes, dollars, rates, and performance metrics.
• Collaborate across departments to develop corrective-action plans.
• Participate in workflow design and post-implementation reviews.
• Educate departments on denial causes and process improvements.
• Protect confidential information and ensure compliance with policies.

Skills

Analytical thinking

Communication skills

Organizational skills

Team collaboration

Independent work

Education

Associate or Bachelor’s in healthcare administration, business, accounting, finance, or health information management

Tools

Epic Hospital Billing

Epic Professional Billing

Excel

Reporting Workbench

Slicer Dicer

Job description

Gritman Medical Center, Inc. in Moscow, ID is seeking a Denials Management Specialist to join the Patient Accounting team on-site. You will analyze, prevent, and resolve claim denials across CAH, specialty clinics, and RHC settings using Epic revenue-cycle tools.

Responsibilities include managing denials and appeals, researching root causes, collaborating with clinical and billing staff, and developing corrective-action plans to improve clean-claim performance and timely reimbursement.