What are the responsibilities and job description for the AR Scpecalist position at REVASCENT LLC?
Position Summary
The Denial Management Specialist is responsible for reviewing, analyzing, and resolving payer denials. The role focuses on root-cause identification, appeal submission, and prevention strategies to improve first-pass acceptance and revenue recovery.
Key Responsibilities
Denial Review & Resolution
- Analyze denial codes, EOBs, and payer correspondence.
- Determine corrective actions: corrected claim, appeal, or documentation request.
- Prepare appeal packets including clinical notes, letters, and supporting evidence.
Root-Cause Analysis
- Categorize denials (coding, eligibility, authorization, bundling, documentation).
- Identify trends and escalate repeat issues to team leadership.
Tracking & Reporting
- Maintain denial logs with actions, outcomes, and recovery amounts.
- Provide weekly denial summary reports and recommendations.
Cross-Functional Collaboration
- Work with coders, billers, and charge entry to correct workflows.
- Provide education on recurring denial patterns.
Qualifications
Required
- 2 years in denial management or AR follow-up.
- Eye experience preferred
- Knowledge of payer policies, appeal timelines, and CARC/RARC codes.
- Strong analytical and written communication skills.
Preferred
- Experience with specialty care denials (especially retina).
- Familiarity with payer portals and electronic appeals.
- Familiarity with PM/EHR systems (e.g., Healthpac, NextTech, ModMed, ECW, Athena, MedInformatics, AdvancedMD).
Core Competencies
- Analytical problem-solving
- Written communication
- Documentation review
- Persistence and follow-through
- Organization
- Attention to detail
Work Environment
- Remote or hybrid based on company structure.
- May require occasional payer calls or joint review meetings.
Salary : $18 - $25