Senior Denials Specialist

Senior Denial & Appeals Specialist (Dermatology Billing | Remote) 💰 Starting at $10/hour | Full-Time | 100% Remote We are seeking an experienced and analytically sharp Senior Denial & Appeals Specialist to take ownership of complex claim denials, manage appeals end-to-end, and drive recovery on high-dollar and high-priority accounts across a multi-location dermatology practice. This is a senior-level individual contributor role for a billing professional who understands denial workflows deeply, navigates payer-specific processes with precision, and produces measurable recovery outcomes. If you have proven experience in dermatology or specialty medical billing , strong appeal-writing ability, and a disciplined approach to managing aging A/R — this role is built for you. 🔍 What You Will Own Denial Management Manage high-volume denial queues across multiple payers, prioritizing by dollar value, filing deadlines, and denial type Analyze denial trends and identify root causes across locations Handle medical, surgical, and cosmetic dermatology denials including: Prior authorization Medical necessity Coding and bundling issues Eligibility rejections Correct, re-code, and resubmit claims with complete supporting documentation Escalate systemic billing or coding issues to leadership Appeals Execution Prepare and submit appeals across all levels (first-level, second-level, external review) Compile documentation including medical records, clinical notes, and payer policies Ensure compliance with payer-specific timelines, requirements, and submission channels Track appeal status and follow up consistently to protect appeal rights Maintain detailed and organized appeal documentation High-Dollar & Complex A/R Work complex and high-value A/R accounts using a structured, priority-based approach Engage payers via phone and portals to resolve disputed claims Identify underpayments and initiate recovery through dispute processes Escalate payer issues when required Maintain accurate and complete account documentation Payer & Coding Expertise Apply strong knowledge of dermatology CPT, ICD-10, and HCPCS coding Interpret payer coverage policies including LCD and NCD guidelines Stay updated on CMS and payer policy changes Support the billing team with complex denial scenarios Reporting & Collaboration Track denial outcomes and contribute to trend reporting Partner with front-end teams to reduce upstream denial drivers Communicate findings clearly to leadership ✅ Required Qualifications 3+ years of medical billing experience with strong focus on denials and appeals Proven experience in dermatology, specialty, or multi-location billing environments Deep understanding of denial codes, remark codes, and payer adjustments Strong working knowledge of CPT, ICD-10, and HCPCS Demonstrated success handling high-dollar and complex A/R accounts Proven ability to write and submit effective appeals across multiple payers Experience using medical billing and practice management systems Strong written communication skills for appeals and documentation ⭐ Preferred Qualifications Experience in dermatology, plastic surgery, or aesthetics billing Familiarity with Availity, Waystar, or similar clearinghouses Experience with EHR platforms such as EMA (Modernizing Medicine) or Nextech CPC, CPMA, or related certification Experience identifying and recovering underpayments through contract analysis Role Details Full-time 100% Remote Rate starts at $10/hour 🕐 Interview Scheduling Notice Initial interviews will be conducted within US Mountain Standard Time (MST) , between 3:00 AM and 1:00 PM MST . We sincerely appreciate your flexibility in accommodating this schedule. 🔒 Data Privacy Statement By applying, you consent to being contacted via the contact information provided in your application for recruitment purposes only.