The Denials Management Analyst supports denials analysis, payor metrics, and trend reporting across multiple systems. This role helps identify root causes, supports process improvement opportunities, and coordinates payor denials, audit activities, and appeals to ensure timely processing. The analyst also monitors day-to-day denial and audit review activity, maintains tracking tools, and supports projects and initiatives for the Denials Management Team.
Requirements & Qualifications
Required Qualifications
- Bachelor's degree, or equivalent combination of education and experience
- 5-7 years in a healthcare revenue cycle environment, including 3 years in third-party collections, AR receivables, and denials management
- Epic PB Resolute experience
- Healthcare revenue cycle management experience in:
- Therapy (Physical/Occupational/Speech)
- Radiology
- Pediatrics/Pediatric Orthopedics
- Anesthesia
- Knowledge of EDI transaction sets including 837I and 837P
- Knowledge of insurance contract rates and terms
- Understanding of registration and collections
- Understanding of government and managed care billing, coverage, and payment rules
- Ability to comprehend payor 835 and paper EOB responses
- Knowledge of NCCI edits, CPT-4, HCPCS, ICD-10, and revenue code standards
- Intermediate Excel skills
Preferred Qualifications
- CRCR certification
- Epic certification
Location
Tampa, Florida, US
Employment Type
Full-time
Experience Level
Senior
Salary Range
$66,872 - $100,318
Remote work allowed
No
Posted
1 month ago
Similar Jobs