Denials Rules Associate
Company: VirtualVocations
Location: Vista
Posted on: May 7, 2025
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Job Description:
A company is looking for a Denials Rules Associate to enhance
the accuracy and impact of Denials Rules across various service
lines.
Key Responsibilities
Create mappings based on payer, CARC/RARC codes, and CPT codes to
support workflow decisions and process automation
Review data sets for inconsistencies and collaborate with internal
teams to manage data effectively
Work with project teams to develop workflows and validate data
mappings while identifying opportunities for process
optimization
Required Qualifications
Intermediate+ level experience with SQL programming
Experience with ETL processes in a SQL environment
Familiarity with 837/835 transaction sets and CARC/RARC codes
Understanding of ICD-10, HCPCS/CPT coding, and medical
terminology
Proficiency in Microsoft Office, especially Excel
Keywords: VirtualVocations, La Habra , Denials Rules Associate, Other , Vista, California
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