Job Description

Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. As a Denials & Appeals Specialist , you will investigate denied healthcare claims, determine the reason for denial, and take the appropriate steps to correct, resubmit, or appeal claims. You will work closely with billing, coding, and client teams to recover missed revenue and identify recurring issues that contribute to denials.

WHAT YOU WILL DO

• Review denied claims and identify the specific reason for denial

• Research payer policies, claim history, and supporting documentation to determine the appropriate resolution

• Correct claim errors and resubmit claims when appropriate

• Prepare and submit reconsiderations and appeals with accurate supporting documentation

• Follow up with payers on outstanding appeals and document all actions and responses

• Monitor denial trends and identify recurring issues affecting reimbursement

• Collaborate with billing and coding teams to address root causes of recurring denials

• Maintain accurate records of denials, appeals, payer responses, and resolution outcomes

• Meet productivity and quality expectations while maintaining accuracy and timely follow-up

WHAT WE ARE LOOKING FOR

• 2+ years of experience in healthcare denials, appeals, medical billing, or a related revenue cycle role

• Strong understanding of common claim denial reasons and payer requirements

• Experience researching denied claims and determining appropriate corrective action

• Experience preparing and submitting insurance claim appeals or reconsiderations

• Ability to interpret EOBs, ERAs, denial codes, and payer correspondence

• Strong attention to detail and ability to manage multiple claims and deadlines

• Excellent written communication skills for preparing clear and well-supported appeals

• Strong problem-solving skills and ability to work independently in a remote environment

• HIPAA-compliant private workspace

NICE TO HAVE

• Experience with Epic, Athena, eClinicalWorks , or another major billing or practice management system

• Medical coding knowledge or certification

• Experience with specific payer types or specialty-specific denials

• Experience analyzing denial trends and root causes

• Experience working with provider groups or hospitals

Job Tags

Similar Jobs