RCM Operations · Full-time
RCM Operations · Full-timeSenior Denial Management Specialist.
Lead denial-prevention and appeal-overturn work across customer engagements. Senior, specialty-aware, payer-aware, and outcome-measured.
About this role
You will lead denial management on a portfolio of customer engagements. The role mixes hands-on appeal work, root-cause analysis, and payer-policy translation into scrub-rule logic. Outcome metrics are denial rate, appeal-overturn rate, and the dollar value of recovered backlog.
What you will own
- Run the denial taxonomy and root-cause analysis on assigned customer accounts.
- Author payer-specific appeal templates and scrub-rule logic that prevent the next round.
- Collaborate with coders to fix upstream documentation or coding issues that drive denials.
- Hit the customer SLA on denial rate, appeal turnaround, and overturn rate.
Must-haves
- 5+ years in denial management or A/R recovery at a billing service or in-house healthcare team.
- AAPC, AHIMA, or HFMA credential.
- Strong understanding of CARC / RARC codes and payer-specific appeal procedures.
- Demonstrable track record of denial-rate reduction and appeal-overturn outcomes.
Nice-to-haves
- Multi-specialty experience.
- Experience leading a denial-management team or training program.
Day in the life
Most of your day is on the customer accounts you own: running denial reviews, drafting appeals, and turning the patterns into scrub-rule changes. You will join one customer call per week per account, the rest is async work.
Compensation
Base $95K–$135K, plus 7% target performance bonus tied to denial-reduction outcomes on your accounts.
Talk to RCM
Ready to recover every dollar your practice earns?
See your projected revenue lift in 60 seconds, or talk to a senior RCM strategist now. No commitment. Same-day slots available.
- 30-day parallel-run guarantee
- Targets written into the contract
- HIPAA · SOC 2 Type II · HITRUST