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Remote Denial Management Jobs (NOW HIRING)

Evergreen Health

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

... Remote in Washington State only Posted wage ranges represent the entire range from minimum to ... that impact denial management processes. 8. Participates in training focused on denial trends ...

Nationwide Credit & Collection Inc.

Be Seen First

Denial Management Specialist

Oak Brook, IL · Remote

$22 - $25/hr

... a remote setting · Strong organizational skills Experience Preferred: · 2 years previous experience in medical denial management · Minimum of 1-year recent Epic experience with the Resolute ...

EvergreenHealth

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

... Remote in Washington State only Posted wage ranges represent the entire range from minimum to ... that impact denial management processes. 8. Participates in training focused on denial trends ...

Vital Connect Inc

Denial Management Specialist

CA · Remote

Description Purpose The Denial Management Specialist role belongs to the Revenue Cycle team and is ... This is a fully remote role** Responsibilities * Comprehensive research and review to resolve payer ...

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Remote Denial Management information

What is remote denial management?

Remote denial management refers to the process of identifying, analyzing, and resolving insurance claim denials from a remote location, typically using digital tools and secure internet connections. Professionals in this role work to ensure that healthcare providers are reimbursed for their services by investigating the reasons for denials, appealing claims, and implementing strategies to reduce future denials. This job is crucial for maintaining healthy cash flow in medical practices and hospitals, and it often involves strong analytical, communication, and problem-solving skills.

What are the key skills and qualifications needed to thrive as a Remote Denial Management Specialist, and why are they important?

To thrive as a Remote Denial Management Specialist, you need a strong understanding of medical billing, insurance claims processing, and healthcare regulations, often backed by experience in revenue cycle management or a related certification. Familiarity with denial management software, electronic health records (EHRs), and payer portals is essential for efficiently tracking and resolving claim denials. Attention to detail, excellent communication, and problem-solving abilities help specialists effectively appeal denials and collaborate with providers and payers. These competencies are crucial to ensure accurate reimbursement, reduce revenue loss, and maintain compliance in a remote healthcare environment.

What is the difference between Remote Denial Management vs Remote Claims Processing?

AspectRemote Denial ManagementRemote Claims Processing
Primary FocusHandling claim denials, appeals, and resolutionProcessing and submitting insurance claims
Skills & CertificationsKnowledge of insurance policies, denial codes, and appeals processesAttention to detail, data entry, basic insurance knowledge
Work EnvironmentHealthcare providers, insurance companies, remoteHealthcare providers, insurance companies, remote
Industry UsageCommon in medical billing and revenue cycle managementCommon in medical billing and claims submission

Remote Denial Management focuses on resolving denied claims through appeals and follow-up, while Remote Claims Processing involves submitting and managing insurance claims. Both roles require insurance knowledge and are vital in healthcare revenue cycle management, but they differ in their primary responsibilities and workflow.

What are some common challenges faced in a Remote Denial Management role, and how can they be addressed?

Remote Denial Management professionals often encounter challenges such as limited access to physical records, communication delays with payers or healthcare providers, and navigating various billing systems. To address these, it's important to develop strong digital organizational skills, maintain clear and proactive communication with team members and external parties, and stay updated on payer policies and denial trends. Leveraging robust denial management software and collaborating with other revenue cycle teams can also help overcome these obstacles and improve claim resolution rates.
More about Remote Denial Management jobs
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What are the most commonly searched types of Denial Management jobs? The most popular types of Denial Management jobs are:
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Remote Denial Management jobs near you
Infographic showing various Remote Denial Management job openings in the United States as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.
Manager - Denial Management (Remote)

Manager - Denial Management (Remote)

Stanford Health Care

Remote

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.
Day - 08 Hour (United States of America)
This is a Stanford Health Care job.
A Brief Overview
The Manager, Denial Management provides strategic leadership and operational oversight for a team of Denial Specialists and is accountable for the timely and accurate resolution of denied and underpaid claims in accordance with current contracts, federal regulations, and SHC policies. This role is responsible for the performance of assigned Accounts Receivable associated with denials, including prevention, recovery, and appeal strategies across hospital and physician services. The Manager serves as a subject matter expert, leads complex denial operations, partners with internal and external stakeholders to address payer trends, and drives continuous improvement to optimize reimbursement and reduce avoidable denials. In addition, the Manager builds and develops a high-performing team by recruiting and onboarding talent; providing ongoing coaching, feedback, and competency-based training; and conducting performance management that aligns individual goals with department objectives. The Manager establishes clear productivity expectations and standard work, sets individual and team targets, and leverages reports and dashboards to monitor timeliness, overturn rates, aged A/R, and appeal quality. The role maintains a robust quality assurance program, including routine audits and documentation standards in Epic and related systems, ensuring accuracy, compliance, and consistency; uses audit results and payer trend analyses to inform targeted education, process improvements, and workload balancing; and proactively removes barriers to sustain productivity and quality outcomes.
Locations
Stanford Health Care
What you will do
  • Lead, develop, and oversee a team of Denial Specialists; provide coaching, training, and performance management to achieve departmental goals and quality standards.
  • Own performance outcomes for assigned denial-related Accounts Receivable, including recovery, overturn rates, aging, write-offs, and compliance with appeal timelines.
  • Establish daily management routines, prioritize work queues, and ensure timely follow-up on high dollar and complex denials and underpayments across hospital (HB) and professional (PB) billing.
  • Conduct and direct root-cause analysis of denial trends to identify mitigation, prevention, and escalation opportunities; design and implement corrective action plans.
  • Oversee appeals and payer escalations; coordinate with Managed Care, Legal, Compliance, and Clinical leaders to interpret contract terms and support successful resolution.
  • Develop, track, and report operational and financial KPIs (e.g., denial rate, initial denial overturn rate, days in A/R, net recovery); present insights and recommendations to leadership.
  • Collaborate with Revenue Cycle stakeholders (Patient Financial Services, Coding, CDI, Case Management, HIM, Access Services, Ambulatory operations) to address internal process issues and external payer behavior.
  • Ensure accurate documentation and audit-ready records in Epic and related systems; uphold privacy and regulatory compliance requirements.
  • Standardize workflows, policies, and procedures; lead continuous improvement initiatives and ensure quality and productivity are effectively monitored and managed.
  • Maintain effective relationships with payers and partner on remediation of systemic issues impacting reimbursement.
  • Plan and allocate resources, manage staffing levels and skill mix, and contribute to budget development and monitoring for the denial management function.
  • Serve as a key resource to leadership for problem-solving difficult issues, analyzing complex accounts, and addressing training needs across the organization.
  • Help develop and implement denial prevention recovery strategies, workflows, and playbooks and monitor their effectiveness through regular KPI reporting.
  • Monitor payer policy changes, national guidelines, and CMS/Medicare/Medicaid updates to ensure compliance and timely adjustment of practices.
  • Maintain denial dashboards, action plans, and performance reports for leadership review.
  • Prepare denial reports and summary findings of analysis for department leadership; maintain clear documentation of analyses and outcomes; escalate systemic risks and barriers as appropriate.

Education Qualifications
  • Bachelor's degree in Business, Health Care Administration, Finance, or a related field or equivalent combination of education/certifications & experience.

Experience Qualifications
  • Seven (7) years of progressively responsible and directly related work experience in healthcare revenue cycle, with a minimum of four (4) years of direct experience in denial management.
  • Three (3) years of leadership experience supervising teams or managing operations in denial resolution or related revenue cycle functions.

Required Knowledge, Skills and Abilities
  • Working knowledge of government and non-government payer requirements, reimbursement rules, laws, and regulations that govern billing/collection activities.
  • Working knowledge of Epic Hospital Billing (HB) and/or Professional Billing (PB); proficiency in Epic reporting preferred.
  • Working knowledge of medical terminology, CPT-4, ICD-10, HCPCS, and modifiers, and how these items drive reimbursement.
  • Ability to analyze and develop solutions to complex problems, including independently identifying problems through data analysis
  • Ability to manage, organize, prioritize, multi-task and adapt to changing priorities
  • Strong analytical and problem-solving skills, with good judgment, attention to detail, and thorough follow-through; ability to interpret complex contracts and payer policies.
  • Demonstrated leadership skills, including staff development, performance management, change management, and the ability to build cross-functional partnerships.
  • Excellent verbal and written communication skills; ability to present complex data clearly to stakeholders and executive leadership; effective negotiation skills for payer escalations.

These principles apply to ALL employees:
SHC Commitment to Providing an Exceptional Patient & Family Experience
Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford's patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.
You will do this by executing against our three experience pillars, from the patient and family's perspective:
  • Know Me: Anticipate my needs and status to deliver effective care
  • Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
  • Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.
Base Pay Scale: Generally starting at $70.52 - $93.43 per hour
The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.

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