Medical Claims Denial & Appeals Specialist

CU Medicine•AURORA, CO

2d•Remote

About The Position

University of Colorado Medicine (CU Medicine) is the region’s largest and most comprehensive multi-specialty physician group practice, providing business operations, revenue cycle, and administrative services for more than 4,000 University of Colorado School of Medicine physicians and advanced practice providers. CU Medicine is seeking a Medical Claims Denial & Appeals Specialist to join its Accounts Receivable Resolution team. The position can be performed fully remotely, and out-of-state candidates will be considered. The Specialist resolves insurance claim denials for assigned departments to enhance revenues for CU Medicine providers. The role prepares effective written appeals to carriers using well-researched reasoning and is independently accountable for resolving denials for assigned divisions. It also involves complex denial management, identifying trends and recurring issues, and supporting the team through escalation, communication, training, and project work. The position requires 3–5 years of experience in medical practice billing, including exposure to denials, appeals, insurance collections, and related follow-up. A bachelor’s degree in a related field is strongly preferred. ICD-10 and CPT coding assessment skills, intermediate PC software experience, advanced verbal and written communication skills, and the ability to apply contract language alongside a comprehensive understanding of claims denial appeal logic are required. CPC certification is preferred. CU Medicine provides generous leave, health plans, and retirement contributions. It is an Equal Opportunity Employer and conducts background investigations for prospective employees. CU Medicine supports a tobacco-free workplace environment.

Requirements

3–5 years of experience in medical practice billing, with exposure to denials, appeals, insurance collections, and related follow-up.
ICD-10 and CPT coding assessment skills.
Intermediate PC software experience.
Advanced verbal and written communication skills.
Ability to apply contract language in conjunction with a comprehensive understanding of claims denial appeal logic.

Nice To Haves

A bachelor’s degree in a related field is strongly preferred.
CPC certification is preferred.

Responsibilities

Appeal denials through coding review, contract review, medical record review, and carrier interaction.
Manage complicated denied claims with a high level of expertise.
Use an analytical approach to resolve denials and identify trends or patterns to proactively address recurring issues.
Use multiple resources to ensure correct appeal processes are followed.
Communicate identified denial patterns to management.
Prioritize and process a large volume of denials while maintaining high-quality work.
Serve as an escalation point for unresolved denial issues.
Inform team members of payer policy changes.
Assist in training new employees as assigned.
Collaborate on special projects as needed.