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.
