Revenue Cycle Clinical Denials Specialist

This role will focus on reviewing complex clinical denials, identifying root causes, preparing compelling written appeals, and helping improve reimbursement outcomes. CornerStone Professional Placement is looking for a Revenue Cycle Clinical Denials Specialist for a reputable client based in Fort Worth, TX.

CornerStone Professional Placement is looking for a Revenue Cycle Clinical Denials Specialist for a reputable client based in Fort Worth, TX. The qualified candidate will have a strong background in clinical denials, hospital billing, and payor appeals. This role will focus on reviewing complex clinical denials, identifying root causes, preparing compelling written appeals, and helping improve reimbursement outcomes.

Location: Fort Worth, TX 76116 – Onsite
Employment Type: Temporary Assignment 
Pay: $28–$32/hour

Responsibilities:
• Review and resolve clinical denials involving authorization, referrals, level of care, medical necessity, and other reimbursement issues
• Research denied claims using clinical documentation, payor policies, contracts, and reimbursement guidelines
• Prepare and submit professional, well-supported payor appeals and perform account and charge reconciliation
• Track denial and appeal outcomes, identify root causes and recurring trends, and recommend process improvements
• Maintain accurate documentation and collaborate with clinical, financial, and revenue cycle stakeholders to resolve reimbursement issues

 

Requirements:
• Previous hospital revenue cycle and clinical denials experience with strong clinical appeal writing skills
• Prior Epic Revenue Cycle / HB Resolute experience — REQUIRED
• Knowledge of CPT, HCPCS, ICD-10, medical terminology, billing forms, payor policies, and healthcare reimbursement
• Working knowledge of medical decision-making criteria tools, including InterQual and Milliman Care Guidelines (MCG)