The Denials Analyst is responsible for tracking and mitigating medical claim denials, identifying trends, and recommending solutions to reduce revenue loss. This role requires strong analytical skills, knowledge of revenue cycle operations, and the ability to communicate findings to stakeholders, including executive leadership.
* Serve as a subject matter expert on denials prevention across the organization
* Ensure compliance with policies and regulatory requirements in denial prevention
* Lead denials prevention projects in collaboration with leadership and care sites
* Participate in process improvement initiatives and committees to enhance efficiency
* Identify opportunities for system and process improvements to reduce denials
* Perform root cause analysis and implement corrective action plans
* Provide recommendations to improve process efficiency to RSC Management
* Meet or exceed department standards and goals
* Three (3) years of work-related experience in medical claims and follow-up
* Knowledge of medical billing and collections
* Ability to read and interpret EOBs (Explanation of Benefits)
* Strong analytical thinking and communication skills
* Proficiency in Microsoft Office
* Ability to work independently and take initiative
* Preferred: HFMA Certification, Epic systems experience, five (5)+ years of medical billing/claims follow-up experience
*Physical Requirements:*
* Manual dexterity to operate computer and office equipment
* Ability to lift and move equipment and supplies, including heavy items
* Roles requiring driving must be able to safely operate a vehicle
None
Complete your application on the company's website