This fully remote Denial Management Representative role is based out of Frisco, TX and sits within a large, nationally recognized healthcare revenue cycle organization serving clients across more than 135 local regions. The position focuses on end-to-end account resolution — from claim follow-up and remittance review through insurance appeals and collections — across Commercial, Managed Care, Medicare, and Medicaid payers. Candidates with 1–4 years of hospital or medical claims experience and a solid command of the revenue cycle will find a structured, team-oriented environment with genuine growth potential and a competitive hourly compensation range.
Perks and Benefits
- Hourly pay range: $15.80 – $23.70; actual rate depends on location, qualifications, and experience
- Signing bonus available for qualified new hires, subject to employment status
- 401(k) retirement plan with up to 6% employer match
- Medical, dental, vision, disability, and life insurance
- Paid time off (vacation and sick leave) — minimum 12 days per year, accruing at approximately 1.84 hours per 40 hours worked
- 10 paid holidays per year; observed holidays paid at time-and-a-half
- Health savings account (HSA); healthcare and dependent flexible spending accounts (FSA)
- Employee Assistance Program and employee discount program
- Voluntary benefits: pet insurance, legal insurance, accident and critical illness insurance, long-term care, elder and childcare support, AD&D, auto and home insurance
- Colorado-based employees receive paid leave in accordance with Colorado's Healthy Families and Workplaces Act
Practice Highlights
- Fully remote position; work-from-home with standard computer terminal setup required
- Responsible for managing a personal desk inventory of accounts — following up on claim submissions, reviewing remittances, and pursuing disputed balances from both government and non-government payers
- Payer mix spans Commercial, Managed Care, Medicare, and Medicaid; familiarity with HMO, PPO, IPA, and Capitation payment structures is directly applicable
- Works within multiple proprietary patient accounting systems: ACE, VI Web, IMaCS, and OnDemand, as well as payer web portals
- Responsibilities include updating plan IDs, correcting demographic and insurance data, identifying billing and coding issues, requesting re-bills or corrected claims, and opening dispute records as needed
- Monitors payer trends and A/R aging; escalates payment delays and problem accounts to supervisory staff in a timely manner
- Collaborates with a broader revenue cycle team; provides coverage support for absent or backlogged colleagues
- Participates in ongoing training seminars, in-services, and team meetings to maintain and expand job knowledge
- Operates within a call-center-style team environment with defined daily productivity and quality standards set by leadership
- Ensures compliance with applicable state and federal laws and regulations governing Managed Care and third-party payers
Qualifications
- High school diploma or equivalent required; some college coursework in business administration or accounting preferred
- 1–4 years of medical claims and/or hospital collections experience
- Thorough understanding of the full revenue cycle: patient access (authorization, admissions) through Patient Financial Services (billing, insurance appeals, collections)
- Intermediate knowledge of Managed Care contracts, contract language, and federal and state requirements for government payers
- Working knowledge of hospital billing form requirements (UB-04) and familiarity with the HCFA-1500 form
- Intermediate proficiency with Explanation of Benefits (EOB) interpretation
- Intermediate skill in Microsoft Office (Word and Excel)
- Minimum typing speed of 45 words per minute
- Above-average analytical and critical thinking skills; ability to problem-solve, prioritize, and follow through independently with minimal supervision
- Vaccination requirements apply; candidates must provide confirmation of all required vaccinations and screenings prior to start of employment, which may include COVID-19, influenza, and any future required vaccines
About the Community
This role is fully remote, making it accessible to candidates across the country regardless of proximity to Frisco, TX. Frisco itself is a rapidly growing suburb north of Dallas in the Dallas–Fort Worth Metroplex — one of the most economically dynamic regions in the country, offering a low state income tax environment, a strong job market, highly rated public schools, and a wide range of dining, entertainment, and outdoor recreation options. Candidates who prefer to be near the home office will find Frisco a family-friendly, amenity-rich community with easy access to the broader DFW metro.