Revenue Recovery & Denials Specialist

Western Missouri Medical Center; Warrensburg (MO); On-site; USD 52,000 - 68,000; Full time

Job summary

Western Missouri Medical Center seeks a Denial Resolution Specialist to review and resolve denied claims using MEDITECH denial work queues and payer codes. You will correct and resubmit claims, request documentation, and pursue reconsiderations and formal appeals to maximize reimbursement.

This role requires 3+ years of healthcare billing, strong attention to detail, and effective communication to meet SLA targets and reduce revenue leakage across the revenue cycle.

Qualifications

• Requires high school diploma or equivalent; bachelor’s degree preferred.
• 3+ years of healthcare billing or revenue cycle experience.
• Experience with MEDITECH EHR/system and SSI clearinghouse.
• Understanding of insurance billing, EOB/ERA interpretation and denial codes.
• Strong attention to detail and ability to meet deadlines.
• Excellent communication and negotiation skills.

Responsibilities

• Review denied claims in MEDITECH denial work queues (DEN-*).
• Analyze EOB/ERA and payer codes (CARC/RARC).
• Correct and resubmit claims; submit reconsiderations or formal appeals.
• Request additional documentation as needed; track status through resolution.
• Manage denial queues daily, meet productivity targets, prioritize high-dollar and aging denials.
• Communicate with payers to clarify denial reasons and requirements.
• Document all actions; ensure CMS and payer policy compliance.

Skills

Analytical thinking

Critical thinking

Attention to detail

Negotiation skills

Communication skills

Time management

Problem solving

Education

High school diploma or equivalent

Bachelor’s degree preferred

Tools

MEDITECH

SSI Clearinghouse

Job description

Western Missouri Medical Center seeks a Denial Resolution Specialist to review and resolve denied claims using MEDITECH denial work queues and payer codes. You will correct and resubmit claims, request documentation, and pursue reconsiderations and formal appeals to maximize reimbursement.

This role requires 3+ years of healthcare billing, strong attention to detail, and effective communication to meet SLA targets and reduce revenue leakage across the revenue cycle.