AR Recovery – Healthcare Denials Specialist III

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🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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FinThrive

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

☁️ SaaS

🤖 Artificial Intelligence

💰 $1M Series A on 2010-02

Healthcare • SaaS • Artificial Intelligence

FinThrive is a healthcare revenue cycle management (RCM) technology company that provides AI-powered, data-intelligence solutions to hospitals, health systems, ambulatory and physician practices, payers and life sciences organizations. Its FinThrive Fusion platform unifies siloed revenue-cycle data to enable predictive analytics, agentic AI workflows, and operational intelligence. Product offerings include patient access, revenue integrity (charge capture and compliance), revenue optimization (claims, denials prevention, payment accuracy), enterprise analytics and learning content designed to improve cash flow, reduce denials and streamline revenue operations. FinThrive positions itself as a SaaS provider delivering AI and automation capabilities to improve financial performance and operational efficiency across the healthcare revenue cycle.

📋 Description

• Learn and understand the Rubixis platform and available resources • Work assigned accounts from start to finish successfully and in a timely manner • Call healthcare insurance companies, affiliates, and providers to resolve contract or payment issues • Analyze contract, billing, cash costing, pricing, and collections on accounts in compliance with billing regulations, policies, and procedures • Investigate insurance payments that deviate from expected payment • Work collaboratively with leadership and team members to confirm, challenge, or provide trending and solutions • Mentor Rep I and Rep II associates • Manage moderately complicated insurance denials and underpayments using Rubixis AR Follow Up software

🎯 Requirements

• 5+ years Hospital Billing with follow up experience • Advanced knowledge of all payer types • Knowledge of Medicare payer rules and processes, including interpreting denial reasons, submitting appeals to Medicare payers, and accessing Medicare portals • Ability to use Medicare Direct Data Entry (DDE) to submit claim corrections, adjustments, and inquiries • Detailed understanding of insurance follow-up, including resolving non-paid, denied, under-paid, and rejected claims for healthcare providers • Experience in UB04 Facility Pricing and Reimbursement variance • Good understanding of revenue cycle • Basic understanding of HIT systems such as EPIC, Paragon, Zirmed, or other billing systems • Problem solving / superior analytical skills • Organized and detail-oriented aptitude • Bachelor's or associate degree • 2+ years of experience in UB-04 Follow-Up and/or Contract/Reimbursement Analysis, including investigation of pricing and reimbursement variances • 2+ years of experience with Medicare processes and systems • Detailed knowledge of Facility Reimbursement contracts, fee schedules, and reimbursement procedures • Advanced MS Excel skills

🏖️ Benefits

• Equal Opportunity Employer • Employment decisions comply with principles embodied in Title VII, the Age Discrimination in Employment Act, the Rehabilitation Act of 1973, the Vietnam Veterans Readjustment Assistance Act of 1974, Executive Order 11246, Revised Order Number 4, and applicable state regulations