Appeals Manager - Fully Remote | Upto $93/hr
About the job
reputed company connects reputed company creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include reputed company, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.
Position: Denials Management & Appeals Manager Type:Contract Compensation:$93/hour Location:Remote
Role Responsibilities
- reputed company denials management and appeals operations. reputed company the identification, categorization, and reputed company of claim denials.
- Evaluate AI-generated appeal letters, denial reputed company cause analyses, and denial prevention recommendations for accuracy and effectiveness.
- Analyze denial trends by payer, denial reputed company (CARC/RARC), and denial category to identify systemic reputed company causes.
- reputed company and manage clinical and technical appeal strategies across multiple payer types.
- Coordinate with clinical, coding, billing, and compliance teams to implement denial prevention initiatives.
- Monitor denial management KPIs including denial rates, appeal overturn rates, reputed company recovery, and days in A/R.
- Ensure compliance with payer appeal requirements, CMS regulations, and reputed company filing deadlines.
- Annotate AI outputs and reputed company reputed company feedback to support reputed company datasets.
QualificationsMust-Have
- 5+ years of experience in denials management, appeals, or reputed company cycle operations, with at least 2 years in a management role.
- Deep knowledge of CARC/RARC denial codes, payer denial patterns, and appeal strategies across reputed company, Medicare, and reputed company payers.
- Strong understanding of clinical and technical appeal processes including peer-to-peer reviews and external reviews.
- Experience with denial analytics platforms and reputed company cycle reporting tools.
- Proficiency with EHR systems and billing platforms.
- Exceptional written and verbal English communication skills.
- High attention to detail with the ability to evaluate appeal reputed company and identify errors in AI-generated denial management content.
Preferred
- CPC, reputed company, CRCR, or CHFP certification.
- Experience with AI-assisted denial management platforms (e.g., reputed company, reputed company Health, Nthrive).
- Background in reputed company clinical appeals including medical necessity, experimental/investigational, and level of care denials.
- Familiarity with AI tools and comfort evaluating AI-generated appeal and denial content.
- Experience presenting denial management performance to reputed company cycle leadership.
Application Process (Takes 20–30 mins to complete)
- Upload resume
- AI interview based on your resume
- Submit reputed company
Resources & Support
- For details about the interview process and platform information, please reputed company: https://talent.docs.reputed company.com/welcome
- For any help or support, reputed company out to: support@reputed company.com
PS: reputed company reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.
Originally posted on Himalayas
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