Denial Management Specialist (Remote)

LEARN Behavioral • Madison, WI

22h • Remote

About The Position

LEARN Behavioral is a national organization dedicated to nurturing children with autism and special needs through evidence-based applied behavior analysis. The Denial Management Specialist provides leadership and training within the Revenue Cycle Management (RCM) Department, reporting to the RCM Manager. This role requires excellent attention to detail, a high standard of customer service, strong communication skills, and proficiency in revenue cycle management. This is a full-time remote opportunity open to candidates in any time zone, with a starting salary of $75,000 annually.

Requirements

• High School diploma required
• 5+ years in revenue cycle management
• At least 1 year in a supervisory or team lead role required
• Experience in Billing Software, Clearinghouse, Payor Portals, and Excel required
• Strong analytical and strategic thinking skills
• Excellent communication and interpersonal skills
• Ability to Identify complex problems and reviewing related information to develop and evaluate options and implement solutions
• Demonstrated ability to work independently and as part of a team in a fast-paced, dynamic environment
• Strong organizational skills and attention to detail, with the ability to manage multiple priorities and deadlines effectively
• Presently eligible to work in the United States

Nice To Haves

• Bachelor’s Degree in Finance, Accounting, Healthcare Administration, or related field preferred

Responsibilities

• Investigate, resolve, and appeal denied or underpaid insurance claims
• Analyze denial trends and payer behavior
• Maintain accurate documentation and follow-up activities
• Partner with Revenue Cycle, Utilization Management, Credentialing, Clinical, and Operations teams
• Monitor assigned denial work queues and productivity metrics
• Assist the RCM Department in leadership coaching, oversight, support, and training for Revenue Cycle Management team members, as needed
• Working closely with payers and operation leads to troubleshoot and resolve claims
• Continuously provide improvements to systems and processes along with support to team members within the RCM Department
• Effectively communicate with our payors’ partners and Operation Leads
• Navigate claims appeals and special projects with payors
• Review all unbilled claims and outstanding A/R
• Prioritize meeting department deadlines
• Process audit requests timely and accurately
• Take the lead on monitoring assigned projects to completion

Benefits

• 401(k)
• personal time off
• paid holidays
• tuition reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED