Revenue Cycle Denials Specialist

Revenue Cycle Denials Specialist

Perform RCM

About the Role

Perform RCM is seeking an experienced Revenue Cycle Denials Specialist to join our revenue cycle team. This position is responsible for researching, resolving, and helping prevent healthcare claim denials to support timely and accurate reimbursement.

The ideal candidate has hands-on experience working insurance denials, researching complex claim issues, preparing appeals and reconsiderations, and working with payers and internal revenue cycle teams to move denied claims toward resolution.

What You'll Do

• Review and resolve assigned insurance claim denials in accordance with payer and client requirements.
• Research denials related to coding, billing, authorization, eligibility, medical necessity, timely filing, and other claim issues.
• Prepare and submit corrected claims, reconsiderations, appeals, and supporting documentation.
• Draft clear and well-supported appeal letters based on denial reasons and payer requirements.
• Research payer policies, medical necessity criteria, coding guidelines, NCCI edits, LCDs, NCDs, and other applicable resources.
• Communicate with insurance carriers and payer representatives to clarify denial and appeal requirements.
• Follow up on submitted appeals and reconsiderations through resolution.
• Collaborate with coding, billing, clinical, authorization, insurance AR, and other revenue cycle teams to resolve complex denials.
• Identify recurring denial trends and communicate findings to management and operational teams.
• Help identify root causes and recommend process improvements to reduce preventable denials.
• Prioritize accounts based on balance, age, filing and appeal deadlines, payer requirements, and client priorities.
• Accurately document research, actions taken, and account status.

What We're Looking For

• High school diploma or equivalent required.
• Previous experience in medical billing, insurance accounts receivable, healthcare revenue cycle management, or a related field required.
• Demonstrated experience researching and resolving healthcare claim denials.
• Experience preparing corrected claims, reconsiderations, and payer appeals.
• Strong analytical, research, and problem-solving skills.
• Knowledge of Medicare, Medicaid, and commercial payer requirements and reimbursement practices.
• Familiarity with payer policies, medical necessity requirements, coding guidelines, and denial management processes.
• Experience with professional and institutional claims preferred.
• Experience working with EHR, practice management, and medical billing systems.
• Strong attention to detail and ability to manage multiple accounts and deadlines.

What Makes Someone Successful in This Role

You are analytical, persistent, and comfortable digging into complex claim issues. You don't simply work a denial—you determine why it occurred, identify the appropriate path to resolution, and follow the account through completion.

You are also able to recognize patterns across accounts and communicate recurring issues that may help prevent future denials. You work effectively across billing, coding, AR, and other revenue cycle functions while maintaining strong productivity and quality standards.

About Perform RCM

Perform RCM provides healthcare organizations with revenue cycle management services designed to improve financial performance and keep the revenue cycle moving forward. Our team combines revenue cycle expertise, technology, and data-driven processes to help our clients manage billing and collections more effectively.

Job Types: Full-time, Part-time

Pay: $22.00 - $24.00 per hour

Expected hours: 40.0 per week

Work Location: In person

Benefits:

Salary : $22 - $24