Denials & AR Recovery Specialist
Core
Recovering insurance revenue from denied, rejected, and underpaid claims by resolving denials, filing appeals, and following up on aging accounts receivable.
Role type
Denials & AR Recovery Specialist
Builds
Insurance revenue recovery and denial prevention feedback loops
Domain
Healthcare revenue cycle management (RCM)
Required skills
Medical billing and claims processing, CARC/RARC denial code interpretation, payer appeals management, accounts receivable follow-up, CPT/ICD-10/HCPCS coding concepts, payer portal navigation, data analysis and reporting, HIPAA compliance
Preferred skills
Telehealth or high-volume E&M billing experience, CPB or CRCR certification, CPC certification, healthcare administration degree, upstream process improvement
Technologies
Payer portals, clearinghouses, practice management systems, billing software, spreadsheets
Responsibilities
Review remittances (ERAs/EOBs) to identify root causes of denials, prepare and submit payer-compliant appeals, correct and resubmit claims with billing/coding errors, monitor and resolve aging accounts receivable, identify underpayments, categorize denials to surface trends for prevention, document activities and report on recovery metrics
Seniority
Mid-level, hands-on IC