# Senior Denials Specialist

**Company:** [Remote Raven](http://jobs.workable.com/companies/hhMk34dkVLDAmx6d9nAW1X.md)
**Location:** Remote
**Workplace:** remote
**Employment type:** Full-time

[Apply for this job](http://jobs.workable.com/view/da35d8cb-61c4-4b2e-bafe-b5a8299fcf7a)

## Description

**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

## Requirements

**✅ 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

## Benefits

**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._