Job Description
Position Summary AdvantixxRCM is seeking an experienced Denial Management Specialist to manage denied, rejected, underpaid, and complex insurance claims. This position is responsible for identifying the root cause of claim denials, correcting billing issues, preparing appeals and reconsiderations, communicating with insurance companies, and pursuing claims through final resolution. The ideal candidate understands medical billing and insurance reimbursement and is comfortable independently resea…
7:30 AM
Log in and pull the overnight denial queue. Your worklist shows 40–80 claims flagged by the payer in the last 24 hours. Sort by do…
8:00 AM
Start working the queue. For each denial, you're reading the remittance advice, identifying the denial reason code (CO-4, CO-50, C…
9:30 AM
Hit a complex medical necessity denial from a Medicare Advantage plan. Open the patient chart, pull the clinical documentation, an…
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