Denial Management Specialist

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🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Abound Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1997

🤝 Non-profit

🌍 Social Impact

Healthcare • Non-profit • Social Impact

Abound Health is dedicated to empowering individuals of all ages with intellectual and developmental disabilities (I/DD) and complex medical needs. They offer a range of services including group homes, supported employment, and specialized consultative services, all centered on person-centered care. Their mission emphasizes the importance of advocacy, inclusion, and supporting not only individuals but also their families and staff.

📋 Description

• Review and analyze denied claims to identify root causes and resolution steps • Collaborate with revenue cycle and clinical teams to correct errors and resubmit claims • Communicate with payers to clarify denial reasons and submit appeals as appropriate • Track denial trends, appeal status, and outcomes with accurate documentation • Develop strategies to reduce denial rates and improve first-pass claim acceptance • Prepare reports on denial metrics, financial impact, and corrective actions for leadership • Monitor compliance with payer guidelines, Medicaid regulations, and internal policies

🎯 Requirements

• 5+ years of experience in healthcare billing, denial management, or revenue cycle operations • Strong analytical, problem-solving, and attention-to-detail skills • Excellent written and verbal communication skills • Ability to collaborate effectively with internal teams and external payers • Proficiency in MS Office (Excel, Word, Teams) and EHR systems (OnTarget preferred) • Knowledge of Medicaid and managed care requirements for I/DD services preferred

🏖️ Benefits

• Competitive health, dental, and wellness benefits beginning on your 60th day of employment • 401(k) plan becomes available after 12 months of employment