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
COMPENSATION AND BENEFITS
Compensation will be discussed during the interview and will reflect the candidate’s experience, qualifications, and relevant healthcare revenue cycle expertise.
Benefits and additional employment details will be discussed during the hiring process.
HIRING PROCESS
Application review → introductory conversation → hiring manager interview → offer.
EQUAL OPPORTUNITY
Raventra Health is an equal opportunity employer. We consider all qualified applicants without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. If you need an accommodation at any stage of the hiring process, please contact us and we will work with you to provide appropriate support.
Location: Remote
Originally posted on Himalayas
Who can apply
Eligible countries: United States. Accepted UTC offsets: UTC-10, UTC-9, UTC-8, UTC-7, UTC-6, UTC-5, UTC+14. Review the full description for employer-specific work authorization, residency and schedule requirements.