DENIAL MANAGEMENT ANALYST

Responsibilities

• Researches and analyzes denials on a daily basis
• Identifies root causes of denials
• Processes resubmissions and appeals with the goal of overturning denials and getting paid by the insurance carrier
• Maximizes revenue for the division

Requirements

• Three to five years of progressive experience in appeal/denial management
• Strong knowledge of health plan requirements
• Strong analytical and statistical analysis skills
• Strong knowledge of EPIC, Microsoft Excel, Word, and PowerPoint
• Knowledge of federal, regional, and state payer coverage patterns (CMS, fiscal intermediary, and Administrative)
• Strong organizational and communication skills
• Professionalism, ability to work with all levels of staff

Qualifications

• Bachelor's Degree preferred (Certified Professional Coder (CPC))
• Associate's Degree required (Medical Billing experience)
• Certified Professional Coder (CPC) required
• EPIC Cadence, HB, PB certifications preferred
• Knowledge of CPT coding and ICD10 diagnosis required

Skills

• Ability to work and effectively multi-task in a fast-paced clinic environment
• Experience working with patients with developmental disabilities

Pay

$49,920.00 - $62,400.00

Schedule

Day shift

Monday through Friday

Scheduled hours: 8:30 AM - 5 PM

Scheduled daily hours: 7.5 HOURS