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Remote Denial Analyst Jobs in Ridgewood, NJ (NOW HIRING)

RightWay ABA

Medical Billing Specialist ABA

Clifton, NJ · Remote

$21 - $28/hr

... Analysis (ABA) therapy practice serving families across New Jersey through five center locations ... claims processing, denial management, and accounts receivable follow-up in a fully remote ...

Deloitte

Epic Denials Management Operator

New York, NY · Remote

$19.75 - $26.25/hr

Conduct Denial categorization and root cause analysis based on remittance information received from ... This is a primarily remote role supporting enterprise Epic support, with minimal travel and ...

Deloitte

Epic Denials Management Operator

Jersey City, NJ · Remote

$18.75 - $25/hr

Conduct Denial categorization and root cause analysis based on remittance information received from ... This is a primarily remote role supporting enterprise Epic support, with minimal travel and ...

Dreem Health

Medical Billing Team Lead

New York, NY · Remote

$58K - $77K/yr

Your Opportunity Behind every clean claim and resolved denial is a patient who can focus on getting ... remote team. * Exceptional attention to detail and strong analytical/problem-solving skills for ...

Posted today

Sunrise Group

Medical Billing Team Lead

New York, NY · Remote

$58K - $77K/yr

Your Opportunity Behind every clean claim and resolved denial is a patient who can focus on getting ... remote team. * Exceptional attention to detail and strong analytical/problem-solving skills for ...

Posted today

Deloitte

Epic Denials Management Operator

Morristown, NJ · Remote

$18.50 - $24.75/hr

Conduct Denial categorization and root cause analysis based on remittance information received from ... This is a primarily remote role supporting enterprise Epic support, with minimal travel and ...

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All JobsDenial Analyst JobsRemote Denial Analyst JobsRemote Denial Analyst Jobs in Ridgewood, NJ

Remote Denial Analyst information

What is a remote denial analyst?

Remote Denial Analysts are professionals who review and analyze denied insurance claims from a remote location. Their primary responsibility is to identify the reasons for claim denials, gather necessary documentation, and communicate with insurance companies to resolve issues. They work with healthcare providers, billing departments, and payers to ensure that claims are processed correctly and payments are obtained. Remote Denial Analysts play a crucial role in improving the financial performance of healthcare organizations by minimizing lost revenue due to denied claims.

What skills and qualifications are needed to thrive as a remote denial analyst?

To thrive as a Remote Denial Analyst, you need a solid understanding of medical billing, insurance claims processes, and healthcare regulations, typically with experience in revenue cycle management or a related field. Familiarity with electronic health record (EHR) systems, claims management software, and knowledge of ICD-10/CPT coding are essential, and certifications like Certified Professional Coder (CPC) can be advantageous. Strong analytical thinking, attention to detail, and effective communication skills help you investigate claim denials and collaborate with providers and payers. These abilities are crucial for maximizing reimbursement, reducing claim denials, and supporting the financial health of healthcare organizations.

What are common challenges faced by remote denial analysts and how can they be managed?

Remote Denial Analysts often encounter challenges such as incomplete documentation, unclear denial reasons, and delays in obtaining additional information from providers or payers. Managing these challenges requires strong analytical skills, attention to detail, and effective communication with both internal teams and external stakeholders. Proactive follow-up, staying updated on payer policies, and leveraging denial management software can help streamline the process and improve resolution rates, even when working remotely.

What is the difference between Remote Denial Analyst vs Remote Claims Processor?

AspectRemote Denial AnalystRemote Claims Processor
Primary RoleReview and analyze insurance claim denials to determine validity and suggest resolutions.Process and review insurance claims for accuracy, completeness, and approval.
Required CredentialsKnowledge of insurance policies, claims processing, and denial reasons; certifications like CPC or CPC-H are common.Basic understanding of insurance claims; certifications are often similar but less specialized.
Work EnvironmentRemote, often in healthcare or insurance companies, focusing on claims review.Remote or office-based, handling claims data and customer interactions.

While both roles involve insurance claims, the Remote Denial Analyst specializes in reviewing denied claims to identify issues, whereas the Remote Claims Processor handles the overall processing and approval of claims. The Denial Analyst requires more expertise in denial reasons and related certifications, making it a more analytical role focused on resolution.

What are popular job titles related to Remote Denial Analyst jobs in Ridgewood, NJ?

For Remote Denial Analyst jobs in Ridgewood, NJ, the most frequently searched job titles are:

What cities near Ridgewood, NJ are hiring for Remote Denial Analyst jobs?

Cities near Ridgewood, NJ with the most Remote Denial Analyst job openings:

Remote Denial Analyst jobs near you

Appeals Manager - Fully Remote | Upto $93/hr

Mercor

New York, NY • Remote

$93/hr

Full-time

Posted 7 days ago

Job description

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Denials Management & Appeals Manager
Type: Contract
Compensation: $70–$93/hour
Location: Remote

Role Responsibilities

  • Lead denials management and appeals operations. Oversee identification, categorization, and resolution of claim denials.
  • Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention recommendations for accuracy and effectiveness.
  • Analyze denial trends by payer, denial code (CARC/RARC), and denial category to identify systemic root causes.
  • Develop 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, revenue recovery, and days in A/R.
  • Ensure compliance with payer appeal requirements, CMS regulations, and timely filing deadlines.
  • Annotate AI outputs and provide structured feedback to support AI training datasets.

Qualifications

Must-Have

  • 5+ years of experience in denials management, appeals, or revenue 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 commercial, Medicare, and Medicaid payers.
  • Strong understanding of clinical and technical appeal processes including peer-to-peer reviews and external reviews.
  • Experience with denial analytics platforms and revenue 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 quality and identify errors in AI-generated denial management content.

Preferred

  • CPC, CCS, CRCR, or CHFP certification.
  • Experience with AI-assisted denial management platforms (e.g., Waystar, Experian Health, Nthrive).
  • Background in complex 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 revenue cycle leadership.

Application Process (Takes 20–30 mins to complete)

  • Upload resume
  • AI interview based on your resume
  • Submit form

Resources & Support

  • For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
  • For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.