Three to five years of progressive experience in appeal/denial management. * Preferred Strong knowledge of health plan requirements. * Strong analytical, statistical analysis skills required.
Three to five years of progressive experience in appeal/denial management. * Preferred Strong knowledge of health plan requirements. * Strong analytical, statistical analysis skills required.
Denial Specialist
Saint Louis, MO · Remote
$22.47/hr
Coordinate data collection, analysis, and reporting related to the denial process. * Monitor compliance and turnaround time (TAT) logs for all notifications. * Fax denial letters to providers. * Make ...
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Denial Specialist
Saint Louis, MO · Remote
$22.47/hr
Coordinate data collection, analysis, and reporting related to the denial process. * Monitor compliance and turnaround time (TAT) logs for all notifications. * Fax denial letters to providers. * Make ...
PB Denial Specialist - EPIC
TX · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
TX · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
$18.50 - $23.75/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
$18.50 - $23.75/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
TN · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
TN · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
KY · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
KY · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
GA · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
GA · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
LA · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
LA · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge Description Master (CDM) processes, authorization trends, and payer denials. Identifies ...
Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge Description Master (CDM) processes, authorization trends, and payer denials. Identifies ...
PB Denial Specialist - EPIC
AL · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
AL · Remote
$19.25 - $24.50/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
Denial Management Specialist
Mauston, WI · On-site
Denial Management Specialist Schedule: Full-time, 80 hours per pay period; Monday-Friday, 8:00am ... Responsible for collecting, researching and analyzing business and operational data. * Provides ...
Denial Management Specialist
Mauston, WI · On-site
Denial Management Specialist Schedule: Full-time, 80 hours per pay period; Monday-Friday, 8:00am ... Responsible for collecting, researching and analyzing business and operational data. * Provides ...
PB Denial Specialist - EPIC
Lisle, IL · On-site
$30.37 - $45.56/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
PB Denial Specialist - EPIC
Lisle, IL · On-site
$30.37 - $45.56/hr
Key Responsibilities: - Identify, analyze, and trend common denial reasons (e.g., medical necessity ... lack of authorization, coding errors, timely filing, incorrect modifiers). - Develop and implement ...
Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge Description Master (CDM) processes, authorization trends, and payer denials. Identifies ...
Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge Description Master (CDM) processes, authorization trends, and payer denials. Identifies ...
Denial Coordinator
Holyoke, MA · On-site
$20.57 - $30.69/hr
Reviews all denial accounts for categorization, level of appeal, special requirements for ... Strong analytical, organizational and time management skills required * Ability to learn quickly ...
Denial Coordinator
Holyoke, MA · On-site
$20.57 - $30.69/hr
Reviews all denial accounts for categorization, level of appeal, special requirements for ... Strong analytical, organizational and time management skills required * Ability to learn quickly ...
Denial Coordinator
Holyoke, MA · On-site
$20.57 - $30.69/hr
Reviews all denial accounts for categorization, level of appeal, special requirements for ... Strong analytical, organizational and time management skills required * Ability to learn quickly ...
Denial Coordinator
Holyoke, MA · On-site
$20.57 - $30.69/hr
Reviews all denial accounts for categorization, level of appeal, special requirements for ... Strong analytical, organizational and time management skills required * Ability to learn quickly ...
Denial Management Specialist
Mauston, WI · On-site
The Denial Management Specialist position gathers, interprets, and reviews data to assess for root cause analytics to then implement process improvement to reduce denials and write offs to optimize A ...
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Denial Management Specialist
Mauston, WI · On-site
The Denial Management Specialist position gathers, interprets, and reviews data to assess for root cause analytics to then implement process improvement to reduce denials and write offs to optimize A ...
Denial Management Specialist
Mauston, WI · On-site
Denial Management Specialist Schedule: Full-time, 80 hours per pay period; Monday-Friday, 8:00am ... Responsible for collecting, researching and analyzing business and operational data. * Provides ...
Denial Management Specialist
Mauston, WI · On-site
Denial Management Specialist Schedule: Full-time, 80 hours per pay period; Monday-Friday, 8:00am ... Responsible for collecting, researching and analyzing business and operational data. * Provides ...
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AR & Denial Management
Richardson, TX · On-site
$19 - $22/hr
Analyze denial trends, identify root causes, and implement corrective actions * Correct claims and submit resubmissions, reconsiderations, and appeals based on payer requirements and contract terms
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AR & Denial Management
Richardson, TX · On-site
$19 - $22/hr
Analyze denial trends, identify root causes, and implement corrective actions * Correct claims and submit resubmissions, reconsiderations, and appeals based on payer requirements and contract terms
Conduct all-source analysis of foreign state and non-state actor denial and deception capabilities, activities, programs, and tradecraft. * Analyze adversary efforts to mislead observers through ...
Conduct all-source analysis of foreign state and non-state actor denial and deception capabilities, activities, programs, and tradecraft. * Analyze adversary efforts to mislead observers through ...
The analyst works assigned claims to correct errors in payment and submitted claim information to optimize the collected revenue for Centra. The goal of the analyst work is to reduce denial dollars ...
The analyst works assigned claims to correct errors in payment and submitted claim information to optimize the collected revenue for Centra. The goal of the analyst work is to reduce denial dollars ...
Denial Analyst information
What are the key skills and qualifications needed to thrive in the denial analyst position, and why are they important?
To thrive as a Denial Analyst, you need analytical skills, knowledge of healthcare claims processing, and a background in medical billing or health administration. Familiarity with claims management software, EHR systems, and certifications such as Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) are highly beneficial. Attention to detail, problem-solving abilities, and strong written and verbal communication help Denial Analysts excel in reviewing and resolving claims issues. These skills ensure effective identification and correction of reimbursement denials, supporting timely revenue recovery for healthcare organizations.
What is a denial analyst?
A Denial Analyst is responsible for reviewing and analyzing medical insurance claims that have been denied or rejected by insurance companies. They investigate the reasons for denials, identify patterns, and work with billing teams, healthcare providers, and insurance companies to resolve issues and recover payments. Denial Analysts also help implement process improvements to reduce future claim denials and ensure compliance with insurance policies and regulations. Their role is critical in optimizing revenue cycle management and improving reimbursement rates for healthcare organizations.
What are some typical challenges faced by denial analysts in their daily work?
Denial Analysts often encounter challenges such as navigating complex healthcare regulations, interpreting varied insurance policies, and addressing high volumes of denied claims. Staying up-to-date on payer guidelines and working closely with coding, billing, and clinical teams to resolve inconsistencies is a key part of the role. It's common to manage competing deadlines and work under pressure to ensure appeals are filed promptly. However, overcoming these challenges develops valuable expertise and can open doors to advanced roles in revenue cycle management or healthcare compliance.
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Job description
IntroductionTo heal, to teach, to discover and to advance the health of the communities we serve.
To learn more about the “Montefiore Difference” – who we are at Montefiore and all that we have to offer our associates, please click here.
Overview
City/State:
Bronx, New YorkGrant Funded:
NoDepartment:
NoMgrWork Shift:
DayWork Days:
MON-FRIScheduled Hours:
8:30 AM-5 PMScheduled Daily Hours:
7.5 HOURSPay Range:
$49,920.00-$62,400.00ResponsibilitiesResearches and analyzes denials on a daily basis, identifies root causes, and processes resubmissions/appeals with the goal of overturning the denial and getting paid by the insurance carrier, maximizing revenue for the division.
Requirements
- Three to five years of progressive experience in appeal/denial management.
- Preferred Strong knowledge of health plan requirements.
- Strong analytical, statistical analysis skills required.
- Strong knowledge of EPIC, Microsoft Excel, Word and PowerPoint skills required.
- Knowledge of federal, regional and state payer coverage patterns (CMS, fiscal intermediary, and Administrative).
- Strong organizational and communication skills; professionalism, able to work with all levels of staff.
- Bachelor's Degree preferred (Certified Professional Coder (CPC)).
- Associate Degree required (Medical Billing experience).
- Certified Professional Coder (CPC) required.
- EPIC Cadence, HB, PB certifications preferred.
- Knowledge of CPT coding and ICD10 diagnosis required.
- Ability to work and effectively multi-task in a fast-paced clinic environment with patients with developmental disabilities.
About Montefiore
Sourced by ZipRecruiter
Company size
501 - 1,000 Employees
Headquarters location
Beachwood, OH, US
Year founded
1882