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
$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
$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 Coding Specialist
Ithaca, NY · Remote
This role focuses on analyzing coding guidelines, driving claims recovery, and identifying root causes of denials. The specialist partners cross-functionally to support a thorough denial management ...
Denial Coding Specialist
Ithaca, NY · Remote
This role focuses on analyzing coding guidelines, driving claims recovery, and identifying root causes of denials. The specialist partners cross-functionally to support a thorough denial management ...
Denial Recovery Specialist
$18.75 - $24.25/hr
Position Summary The Denial Recovery Specialist is responsible for reviewing, analyzing, and resolving denied professional billing claims to ensure accurate and timely reimbursement. This role ...
Denial Recovery Specialist
$18.75 - $24.25/hr
Position Summary The Denial Recovery Specialist is responsible for reviewing, analyzing, and resolving denied professional billing claims to ensure accurate and timely reimbursement. This role ...
Denial Recovery Specialist
Chicago, IL · On-site
$18.75 - $24.25/hr
Position Summary The Denial Recovery Specialist is responsible for reviewing, analyzing, and resolving denied professional billing claims to ensure accurate and timely reimbursement. This role ...
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Denial Recovery Specialist
Chicago, IL · On-site
$18.75 - $24.25/hr
Position Summary The Denial Recovery Specialist is responsible for reviewing, analyzing, and resolving denied professional billing claims to ensure accurate and timely reimbursement. This role ...
Denial Recovery Specialist
Chicago, IL · On-site
$18.75 - $24.25/hr
Position Summary The Denial Recovery Specialist is responsible for reviewing, analyzing, and resolving denied professional billing claims to ensure accurate and timely reimbursement. This role ...
Denial Recovery Specialist
Chicago, IL · On-site
$18.75 - $24.25/hr
Position Summary The Denial Recovery Specialist is responsible for reviewing, analyzing, and resolving denied professional billing claims to ensure accurate and timely reimbursement. This role ...
... denial prevention • Maintain compliance with Medicare, Medicaid, third-party payer regulations, and healthcare industry standards • Perform medical record reviews, documentation analysis, and ...
... denial prevention • Maintain compliance with Medicare, Medicaid, third-party payer regulations, and healthcare industry standards • Perform medical record reviews, documentation analysis, and ...
Claims Denial Managment/AR Specialist
Addison, TX · On-site
$17.50 - $23.25/hr
Review and analyze denied, underpaid, and rejected medical claims to determine root causes ... Identify denial patterns or trends across payers, coding categories, or service lines.
Claims Denial Managment/AR Specialist
Addison, TX · On-site
$17.50 - $23.25/hr
Review and analyze denied, underpaid, and rejected medical claims to determine root causes ... Identify denial patterns or trends across payers, coding categories, or service lines.
Analyze 835 remittance files to identify denial reason codes (CO-4, CO-97, CO-16, PR-96, etc.) and trace root causes back to submission or coding errors * Identify coding-driven denial trends ...
Analyze 835 remittance files to identify denial reason codes (CO-4, CO-97, CO-16, PR-96, etc.) and trace root causes back to submission or coding errors * Identify coding-driven denial trends ...
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 ...
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
Professional Fee Radiology Coding and Billing Experience required The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and ...
Professional Fee Radiology Coding and Billing Experience required The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and ...
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
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 ...
AR Follow-up and Denial Specialist
Bethesda, MD · On-site
$24 - $33/hr
This role requires strong analytical, coding, and communication skills, with a focus on denial prevention, timely appeals, and collaboration across the revenue cycle team. What you will do: Claims ...
AR Follow-up and Denial Specialist
Bethesda, MD · On-site
$24 - $33/hr
This role requires strong analytical, coding, and communication skills, with a focus on denial prevention, timely appeals, and collaboration across the revenue cycle team. What you will do: Claims ...
Overview RN Clinical Denial Recovery Analyst | Enterprise Denials Turn clinical insight into revenue recovery--driving accurate appeals and reducing denials across the enterprise. ???? Work Style:
Overview RN Clinical Denial Recovery Analyst | Enterprise Denials Turn clinical insight into revenue recovery--driving accurate appeals and reducing denials across the enterprise. ???? Work Style:
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services ...
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 job?
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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Full-time
Posted 27 days ago
Job description
Overview
Work remotely while using your denial management expertise to make a direct impact on healthcare operations.
Work Style: Remote
Location Requirement: Must reside in an approved state (FL, GA, PA, NC, SC, TN, or TX)
FTE: Full-Time (1.0 FTE)
Responsible for maintaining low denial rates and optimizing reimbursement across the enterprise by ensuring high coding standards and effective denial management practices. Leads and supports initiatives to improve coding accuracy, reimbursement outcomes, and appeal turnaround times.
Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge Description Master (CDM) processes, authorization trends, and payer denials. Identifies opportunities for performance improvement and implements strategies to enhance revenue cycle outcomes.
Educates departments on appropriate charging, billing, and coding practices to ensure regulatory compliance. Collaborates with Managed Care, Compliance, and operational teams to resolve complex issues with departments and payers, driving sustainable improvements in reimbursement and denial prevention.
Responsibilities
Key Responsibilities:
Qualifications
Minimum Qualifications:
Work remotely while using your denial management expertise to make a direct impact on healthcare operations.
Work Style: Remote
Location Requirement: Must reside in an approved state (FL, GA, PA, NC, SC, TN, or TX)
FTE: Full-Time (1.0 FTE)
Responsible for maintaining low denial rates and optimizing reimbursement across the enterprise by ensuring high coding standards and effective denial management practices. Leads and supports initiatives to improve coding accuracy, reimbursement outcomes, and appeal turnaround times.
Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge Description Master (CDM) processes, authorization trends, and payer denials. Identifies opportunities for performance improvement and implements strategies to enhance revenue cycle outcomes.
Educates departments on appropriate charging, billing, and coding practices to ensure regulatory compliance. Collaborates with Managed Care, Compliance, and operational teams to resolve complex issues with departments and payers, driving sustainable improvements in reimbursement and denial prevention.
Responsibilities
Key Responsibilities:
- Manages clinical denials from assigned work queues, including claim resubmissions, authorization verification, payer reprocessing, reconsiderations, and appeals
- Partners closely with Managed Care and payers to reduce denials and improve reimbursement outcomes
- Analyzes denial trends and develops recommendations to improve coding accuracy and documentation practices
- Meets established productivity and accuracy standards, including reviewing approximately 30 accounts per day with a 98% accuracy rate
- Applies coding guidelines (NCCI, ICD-10, CPT, HCPCS, CMS) to accurately review, code, and correct accounts
- Collaborates with department managers to track, report, and resolve denials, including participating in audits and compliance reviews
- Identifies root causes of denials, tracks trends, and escalates findings to leadership for follow-up and process improvement
- Works across multiple payer work queues, including Medicare, Medicaid, government, and commercial payers
- Research denials related to authorization, medical necessity, non-covered services, coding, and billing issues, ensuring timely resolution and appeal submission
- Prepares and submits detailed, well-supported reconsiderations and appeals based on medical record review and payer requirements
- Monitors payer communications and policy updates to identify risks impacting reimbursement and authorization requirements
- Reviews and corrects coding, including modifier usage, diagnosis sequencing, and compliance with coding guidelines
- Reviews and adjusts charges as needed based on documentation, billing, and regulatory standards
- Educates departments on denial prevention strategies, including improvements in coding, charging, and authorization processes
Qualifications
Minimum Qualifications:
- High School Diploma or GED required
- One of the following coding certifications required: CPC, COC, RHIT, RHIA, or CCS
- 1-2 years of coding experience, along with 1-2 years of denial management and/or insurance-related experience
About UF Health
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Gainesville, FL, US
Year founded
1958