About this role
Denials Analyst
remote type On Site
locations Eisenhower Medical Center time type Full time posted on Posted 2 Days Ago job requisition id R0276241 Default Work Shift:Day (United States of America)Hours:40Salary range:$21.75 - $33.04Schedule:Full TimeShift Hours:8 Hour employeeDepartment:Denials Analytics
Job Objective: Researches and resolves claim denials, ADR requests and certs; submits and tracks appeals, notes trends and provides monthly reports. Responds to audit requests (including RAC) from payors and maintains a Library of Payer reference material regarding requirement for pre authorization, medical necessity and documentation requirements. Works with the Revenue Cycle stakeholders (e.g. Admitting, Coding, Provider Liaisons, etc.) to provide information related to denials and opportunities for process improvement. Job Description: Education: Required: High school diploma, GED or higher level degree Preferred: Associate's degree Licensure/Certification: Preferred: Certified coder or currently enrolled in a coding program Experience: Required: Three (3) years of hospital/professional billing experience with an emphasis in denied claims follow-up, appeals processing, managed care and/or Medicare/Medi-Cal reimbursement methodologies Preferred: Patient accounting experience in a high-volume claims’ environment Reports To: Manager-Denials Analytics Supervises: N/A Ages of Patients: N/A Blood Borne Pathogens: Minimal/ No Potential Skill