Senior Denials & Appeals Specialist (Remote)

RiseMe; Dallas (TX); On-site; USD 60,000 - 85,000; Full time

Job summary

UT Southwestern Medical Center is seeking a Technical Denials Management Specialist II for the Revenue Cycle Department. You will review, research, and resolve claim denials and appeals, maximizing collections, with a strong emphasis on EPIC Resolute proficiency.

The role requires independent and team-based work, leadership duties, and the ability to guide processing improvements while handling complex denials in a remote setting for the Greater Dallas area.

Qualifications

• 4 years' experience in medical claims recovery and/or collections with High School Diploma.
• Experience with NCCI edits, LCD/NDC, and bundling denials.
• Experience with contacting health insurance carriers.
• Epic experience and ability to read Explanation of Benefits.

Responsibilities

• Contact payers to obtain reimbursement for unpaid accounts and follow up on denials.
• Interpret contracts and Medicare/Medicaid rules to ensure proper reimbursement.
• Lead workflow activities and support production goals and deadlines.
• Train and mentor new team members on payer requirements and Epic processes.

Skills

Leadership

Team coordination

Communication

Problem solving

Multitasking

Training staff

Education

High School Diploma or Associate's Degree

Tools

EPIC Resolute

EPIC

NCCI edits

Job description

UT Southwestern Medical Center is seeking a Technical Denials Management Specialist II for the Revenue Cycle Department. You will review, research, and resolve claim denials and appeals, maximizing collections, with a strong emphasis on EPIC Resolute proficiency.

The role requires independent and team-based work, leadership duties, and the ability to guide processing improvements while handling complex denials in a remote setting for the Greater Dallas area.