Denial Specialist, Part Time, Remote

HIM Denials Specialist

The HIM Denials Specialist is responsible for managing claim denials, including thoroughly reviewing the denial and supporting documentation (e.g., medical record, denial rationale, and appeal rationale). If warranted, the Denials Specialist will ensure that an appeal letter is well‑written and submitted in a timely manner. The HIM Denials Specialist will also maintain the denials database, perform follow‑up, and process appeals promptly.

The HIM Denials Specialist has full access to patient health information and will work on‑site. Shift: Flex remote, 24 hrs. per week.

• High School Diploma or equivalent required. Associate degree in related field preferred.
• Current AHIMA or AAPC credential (RHIA / RHIT / CCS / CCA / CPC / CPC-H) preferred.
• Enrollment in accredited Health Information Management and/or medical coding program accepted.
• At least 1 year of work experience in insurance, customer service, healthcare, or related field is preferred.
• Excellent communication, computer and typing skills required.
• Ability to tolerate viewing computer monitors for extended periods of time.
• Familiarity of medical terminology, anatomy, physiology, and various medical specialties preferred.
• Familiarity of ICD-10 CM, ICD-10 PCS, CPT, and MS-DRG preferred.
• Familiarity of insurance regulations, denial codes, and denial rationale preferred.
• Detail oriented, and able to work with increasing independence.
• Ability to handle difficult interactions with resilience and professionalism.
• Able to identify problematic situations / issues and work with management to resolve or improve them.

• Must pass a basic FIT test to include bending, stooping, standing, and sitting for extended periods of time.
• Must be able to lift and carry up to 30 pounds.
• Requires eye-hand coordination and manual dexterity.
• Requires normal vision/hearing range (+/- assistive devices such as glasses or hearing aids).

Entry level

Part-time

Other

Education Management