Medical Denials Specialist

TEKsystems • Littleton, CO

5d • $22 - $25 • Remote

About The Position

The Denials Specialist is responsible for reviewing, analyzing, and resolving denied claims within Virta Health’s revenue cycle operations. This role involves reviewing denied claims via Athena worklists and payer portals, identifying root causes of denials such as coding issues, coordination of benefits, and eligibility problems. The specialist will perform research using internal systems and billing guides, collaborate with internal revenue cycle specialists to correct claims, and resubmit claims ensuring appropriate reimbursement. Additionally, the role requires tracking and organizing denial data in Excel/Google Sheets, communicating with customers when payer-side correction is not applicable, supporting backlog cleanup and workflow improvements, and contributing to evolving processes as Virta optimizes Athena utilization.

Requirements

• Min 6 months years experience in denials management
• Athena: comfort navigating worklists, denial review, and workflows
• Know how to use payer portals to pull denial reports and resubmit information
• Ability to diagnose why a claim was denied and do internal research to solve the problem
• Microsoft Excel Experience

Nice To Haves

• Athena: 1+ year preferred
• strong relationship-building skills, particularly in working directly with payer contact

Responsibilities

• Reviewing denied claims via Athena worklists and payer portals
• Identifying root causes of denials (coding issues, COB, eligibility, etc.)
• Performing research using internal systems and billing guides
• Collaborating with internal revenue cycle specialists to correct claims
• Resubmitting claims and ensuring appropriate reimbursement
• Tracking and organizing denial data in Excel/Google Sheets
• Communicating with customers when payer-side correction is not applicable
• Supporting cleanup of backlog/worklists and improving workflows
• Contributing to evolving processes as Virta optimizes Athena utilization

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

What This Job Offers

• Career Level: Mid Level
• Education Level: No Education Listed