Overview

Have you ever wanted to use your clinical expertise to tackle challenging puzzles behind the scenes in healthcare? At St. Elizabeth Healthcare, we are looking for a dedicated Specialist Clinical Denial to join our team. This is a fully remote position that you can perform from anywhere in the world. You will play a vital part in reviewing and resolving post-service denials that require expert clinical input and interpretation. For over 160 years, our organization has remained a trusted healthcare leader across Kentucky, Indiana, and Ohio. If you enjoy solving complex problems while supporting a compassionate mission, this opportunity is for you.

Key Responsibilities

Review complex post-service denials requiring clinical interpretation and analysis.
Determine the appropriate steps to resolve denials efficiently and accurately.
Collaborate with various internal teams to ensure proper clinical documentation and coding alignment.
Maintain thorough records of all denial resolution activities and outcomes.
Support overall revenue cycle health by reducing preventable clinical denials.

Requirements

Active clinical background with relevant healthcare experience.
Strong understanding of medical terminology, clinical documentation, and insurance denial processes.
Exceptional analytical skills with high attention to detail.
Ability to work independently in a fully remote environment.
Strong communication skills for effective collaboration across teams.

What You'll Gain

We invest in your personal and professional growth from day one. You will receive competitive pay along with comprehensive health coverage starting within your first thirty days. Enjoy generous paid time off and flexible scheduling that respects your life outside of work. We also offer retirement savings plans with employer matching, tuition reimbursement, professional development opportunities, wellness programs, and clear pathways for career advancement.