Medical Claims Denial & Appeals Specialist

CU Medicine•Aurora, CO

3d•$29 - $35•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 in support of more than 4,000 University of Colorado School of Medicine physicians and advanced practice providers. CU Medicine is seeking a highly motivated Medical Claims Denial & Appeals Specialist for its Accounts Receivable Resolution team. The position can be performed 100% remotely, and candidates from out of state will be considered. The Specialist resolves insurance claim denials for assigned departments to enhance revenue for CU Medicine providers. The role involves preparing effective written appeals based on well-researched logic and independently managing denial resolution for assigned divisions.

Requirements

3–5 years of experience in medical practice billing, including 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.
A solid understanding of contract language and the ability to apply it alongside a comprehensive understanding of claims denial appeal logic.

Nice To Haves

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 available resources to ensure the 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.