Top 86 Eligibility specialist Jobs in Black Hawk, Co

Credentialing and Denials Specialist
Critical Care Pulmonary and Sleep Associates —Lakewood, CO
- $26 - $29 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- AD&D insurance
- Paid holidays
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Detentions Specialist (Eligibility List - No Current Open Positions Available)
Gilpin County —Black Hawk, CO
- $19.61 - $26.52 an hour
- Weekends as needed
- Background check
- 18 years or older
- Word processing
- Paid holidays
- Disability insurance
End User Support Specialist
Native Roots —Lakewood, CO
- $60,000 - $72,000 a year
- Full-time
- Research
- Mid-level
- Office
- Disability insurance
- Health insurance
Quick Apply
2d
Parks Construction Specialist I
Jefferson County Colorado —Golden, CO
- $29.76 - $37.20 an hour
- Online Application
- CPR Certification
- Construction site
- CDL
- Paid holidays
- Health insurance
10d
International Relations Specialist (Africa)
US Office of the Secretary of the Interior —Lakewood, CO
- $106,437 - $158,322 a year
- Part-time
- Hybrid work
- Background check
- Writing skills
- Pass drug screening
3d
TTO Professional I Contract Admin – Partnership Agreement Analyst
National Laboratory of the Rockies —Golden, CO
- $57,900 - $95,500 a year
- Full-time
- Pass drug screening
- Data analysis skills
- Mid-level
- 403(b) matching
- AD&D insurance
Professional Research Assistant
University of Colorado Boulder —Boulder, CO
- $48,000 - $50,000 a year
- Full-time
- Adults
- University
- Bachelor's degree
- Health insurance
- Dental insurance
10d
Intake Specialist
AdaptHealth, LLC —Lakewood, CO
- $22 - $24 an hour
- On call
- Background check
- Management
- Administrative experience
- Paid parental leave
- Health savings account
Quick Apply
12d
Amazon FBA Specialist
VanEssential —Boulder, CO
- $80,000 a year
- Email
- Inventory management
- Office
- In-person
- Profit sharing
- Health savings account
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5d
Field Facilities Professional (Technician)
Terracon —Wheat Ridge, CO
- $62,370 - $85,000 a year
- Construction site
- Mid-level
- Ability to lift 50 pounds
- Paid holidays
- Health insurance
Security Testing Specialist Sr - Application Security - Tuesday - Saturday - 1pm MST - 9pm MST
PNC Financial Services Group —Lakewood, CO
- $112,000 - $228,800 a year
- Full-time
- Master's degree
- 8 years
- Bachelor's degree
- Wellness program
- Health savings account
Software Security Specialist Sr - Software Security Coach
PNC Financial Services Group —Lakewood, CO
- $80,000 - $185,150 a year
- Full-time
- Office
- Master's degree
- 8 years
- Wellness program
- Health savings account
Data Science Expert - Emerging Fraud Risk Lead
PNC Financial Services Group —Lakewood, CO
- $133,000 - $217,700 a year
- Full-time
- Office
- Master's degree
- 8 years
- Wellness program
- Health savings account
1d
Eagle Permits Support Specialist - US Fish & Wildlife Service
Conservation Legacy —Denver, CO
- Full-time
- Microsoft Word
- Microsoft Outlook
- Mid-level
10d
Program Specialist - Ruma
Brothers Redevelopment, Inc. —Edgewater, CO
- $20 - $22 an hour
- Hybrid work
- Spanish
- Computer literacy
- Writing skills
- 403(b) matching
- Paid holidays
Guest Experience Expert
Marriott International, Inc —Golden, CO
- $22 an hour
- Full-time
- Hotel
- High school diploma or GED
- Entry level
Business Support Professional II - Catalytic Carbon Transformation and Scale-up Center
National Laboratory of the Rockies —Golden, CO
- $44,500 - $71,200 a year
- Full-time
- Microsoft Excel
- Pass drug screening
- Mid-level
- 403(b) matching
- AD&D insurance
Specialist -HR Investigations Employee Relations
Boulder Valley School District —Boulder, CO
- $40,573.50 - $60,860.50 a year
- Background check
- School experience
- Spanish
- Health insurance
- Dental insurance
2d
Asset Protection Specialist
Safeway —Boulder, CO
- $18.00 - $26.25 an hour
- Full-time
- 18 years or older
- Fair chance
- Teaching
- Paid holidays
- Disability insurance
Quick Apply
6d
Retreats Partnership Specialist
Fellowship of Catholic University Students —Golden, CO
- $48,000 - $72,000 a year
- Full-time
- Spanish
- Public speaking
- Mid-level
- Paid parental leave
- Health savings account

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Credentialing and Denials Specialist

Critical Care Pulmonary and Sleep Associates -
Lakewood, CO

Quick Apply

Job Details

Full-time
$26 - $29 an hour

Benefits

AD&D insurance
Paid holidays
Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Microsoft Word
Appeals
Microsoft Excel
Microsoft Outlook
Customer service
Provider enrollment for medical credentialing
Medical coding guidelines
Taxonomy
High school diploma or GED
Medical insurance appeals management
Data interpretation
Insurance claims appeal handling
Medical terminology

Full Job Description

Company & Position Summary:

Critical Care, Pulmonary and Sleep Associates is a multispecialty private physician practice, providing Critical Care, Pulmonary and Sleep medical services to the Denver metro area for over 40 years. Our dedicated team of Board-Certified Critical Care, Pulmonary and Sleep Physicians along with our skilled clinical and administrative staff exclusively serve nine Common Spirit and AdventHealth Hospital ICU’s and multiple outpatient clinic locations spanning Colorado’s front range. CCPSA’s organizational culture exemplifies excellence in patient centered care, unified teamwork, and a highly collaborative approach in all business and clinical operations. We are currently seeking a Credentialing and Denials Specialist to join our committed team of professionals.

The Credentialing and Denials Specialist is responsible for provider credentialing across commercial insurance payers, government programs, hospitals, and other healthcare organizations while serving as the primary resource for insurance claim denial resolution. This position ensures providers are appropriately credentialed, enrolled, appointed, and privileged to support timely reimbursement and uninterrupted patient care while researching, appealing, and resolving denied claims. The individual in this role partners with internal teams and insurance carriers to identify reimbursement trends, improve revenue cycle performance, maintain regulatory compliance, and support the organization's financial health. This role requires a commitment to the CCPSA culture of collaboration while identifying opportunities for continuous improvement and supporting the organization's shared values.

Essential Responsibilities and Tasks:

Provider Credentialing, Enrollment & Privileging

Ensure CCPSA providers are credentialed, enrolled, appointed, and privileged with commercial and government payers, hospitals, and other healthcare organizations to support uninterrupted clinical operations and timely reimbursement.
Complete provider enrollment, credentialing, recredentialing, revalidation, appointment, privileging, and ongoing maintenance activities with commercial and government payers, hospitals, and other healthcare organizations.
Coordinate provider onboarding activities related to credentialing and privileging, including hospital application requirements and other required pre-start activities, as applicable.
Maintain provider credentialing records and monitor compliance with licenses, certifications, DEA registrations, malpractice coverage, continuing education, and other credentialing requirements.
Maintain accurate provider information within credentialing systems, payer portals, hospital credentialing systems, CAQH, and other required databases.
Ensure all credentialing files meet standards set by the NCQA, TJC, CMS, hospitals, and payer-specific guidelines.
Serve as the primary point of contact for provider credentialing, enrollment, appointment, and privileging questions.

Denials Management

Review assigned denial work queues and investigate denied claims for accurate and timely resolution.
Research and appeal insurance claim denials through review of coding, medical records, payer contracts, reimbursement guidelines, and applicable documentation.
Maintain advanced knowledge of payer websites, reimbursement guidelines, and appeal processes for commercial and government payers, including Medicare, Medicaid, Medicare Advantage, Tricare, VA, and other payer plans.
Analyze denial trends and identify root causes to proactively reduce future denials.
Escalate denial issues and communicate recurring trends or payer policy changes to leadership.
Ensure appeals are submitted within payer filing deadlines.

Revenue Cycle Support

Stay current on payer policies, reimbursement regulations, and credentialing requirements.
Assist with educating team members regarding payer updates, denial trends, and process improvements.
Accurately document denial investigations, appeals, credentialing activities, and resolutions within appropriate systems.
Collaborate with providers, payers, coding, billing, and other internal teams to resolve reimbursement issues and support efficient revenue cycle operations.
Participate in quality improvement initiatives and projects that enhance revenue cycle performance.
Perform other duties as assigned by the manager.

Skills, Education and/or Work Experience Requirements:

Minimum of two (2) years of experience in provider credentialing, payer enrollment, medical billing, denial management, or revenue cycle operations. Hospital credentialing and privileging experience preferred.
Demonstrated experience researching, appealing, and resolving insurance claim denials.
Working knowledge of medical terminology, provider taxonomy, commercial and government payer guidelines, credentialing requirements, and healthcare reimbursement methodologies.
Knowledge of hospital credentialing and privileging processes preferred.
Excellent analytical, organizational, problem-solving, and critical thinking skills.
Demonstrated commitment to exceptional customer service through professional communication, responsiveness, and timely follow-up.
Ability to work independently while effectively managing multiple competing priorities and consistently meeting deadlines.
Strong written and verbal communication skills.
Proficiency in Microsoft Outlook, Word, Excel, internet research, and payer portals.
Experience with EPIC Resolute Professional Billing strongly preferred.
High School Diploma or GED required.

Compensation:

Competitive hourly compensation.
Benefits effective date-of-hire (no waiting period).
Comprehensive medical benefits. Company covers 80-85% percent of individual or family premium.
Dental and vision benefits offered at no cost to the employee. Company covers 100% of individual or family premium.
Life and AD&D benefits.
Optional additional life & disability insurance at group discounts.
PTO and holiday pay.
401k benefits with company contribution after eligibility period.
Position reports to RCM Manager.

Quick Apply

Refine Your Search

eligibility specialist jobs in black hawk, co

Credentialing and Denials Specialist

Detentions Specialist (Eligibility List - No Current Open Positions Available)

End User Support Specialist

Parks Construction Specialist I

International Relations Specialist (Africa)

TTO Professional I Contract Admin – Partnership Agreement Analyst

Professional Research Assistant

Intake Specialist

Amazon FBA Specialist

Field Facilities Professional (Technician)

Security Testing Specialist Sr - Application Security - Tuesday - Saturday - 1pm MST - 9pm MST

Software Security Specialist Sr - Software Security Coach

Data Science Expert - Emerging Fraud Risk Lead

Eagle Permits Support Specialist - US Fish & Wildlife Service

Program Specialist - Ruma

Guest Experience Expert

Business Support Professional II - Catalytic Carbon Transformation and Scale-up Center

Specialist -HR Investigations Employee Relations

Asset Protection Specialist

Retreats Partnership Specialist

I want to receive the latest job alert for eligibility specialist in black hawk, co

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