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