Denials & Appeals Specialist

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