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Denial Management Analyst Jobs (NOW HIRING)

Nationwide Credit & Collection Inc.

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Denial Management Specialist

Oak Brook, IL · Remote

$22 - $25/hr

Denial Management Specialist Essential Job Functions · Investigates insurance denials to identify ... Able to analyze EOBs at a claim level · Identifies claims needing correction and forwards to ...

Vital Connect Inc

Denial Management Specialist

CA · Remote

Description Purpose The Denial Management Specialist role belongs to the Revenue Cycle team and is ... Possesses proven analytical and decision-making skills to determine what selective clinical ...

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How much do denial management analyst jobs pay per year?

As of Jun 9, 2026, the average yearly pay for denial management analyst in the United States is $84,961.00, according to ZipRecruiter salary data. Most workers in this role earn between $65,000.00 and $102,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Denial Management Analyst, and why are they important?

To thrive as a Denial Management Analyst, you need strong analytical skills, knowledge of medical billing and coding, and an understanding of insurance claim processes, typically supported by a degree in healthcare administration or a related field. Familiarity with revenue cycle management (RCM) software, electronic health records (EHR) systems, and relevant certifications such as Certified Revenue Cycle Specialist (CRCS) is often required. Attention to detail, problem-solving abilities, and effective communication skills are vital for collaborating with providers and payers to resolve claim denials. These skills ensure accurate claims processing, maximize reimbursements, and help maintain the financial health of healthcare organizations.

What are some common challenges faced by Denial Management Analysts, and how can they be addressed?

Denial Management Analysts often encounter challenges such as navigating complex insurance policies, identifying patterns in claim denials, and balancing high volumes of cases. To address these, analysts rely on strong analytical skills and effective communication with both internal billing teams and external payers. Staying up-to-date on payer requirements, leveraging denial management software, and fostering collaborative relationships with clinical and coding staff can significantly enhance both efficiency and resolution rates.

What does a Denial Management Analyst do?

A Denial Management Analyst is responsible for reviewing and analyzing insurance claim denials in healthcare settings. They identify patterns or reasons for denials, research solutions, and work with billing departments, payers, and healthcare providers to resolve issues and recover lost revenue. Their work helps ensure accurate billing, improves reimbursement rates, and reduces the number of denied claims over time.

What is the difference between Denial Management Analyst vs Claims Analyst?

AspectDenial Management AnalystClaims Analyst
CredentialsTypically requires a healthcare or insurance-related certification, such as CPC or CCSOften requires a healthcare administration or insurance certification, like CPC or similar
Work EnvironmentWorks primarily in healthcare billing departments, insurance companies, or hospital revenue cyclesWorks in insurance companies, healthcare providers, or third-party administrators
Industry UsageCommonly employed in healthcare revenue cycle management to address claim denialsUsed across insurance and healthcare sectors to analyze claims and resolve issues

Both roles focus on claims processing and reimbursement, but the Denial Management Analyst specializes in identifying and resolving claim denials to improve revenue recovery, whereas the Claims Analyst handles broader claims processing and analysis. The Denial Management Analyst's role is more targeted toward denial prevention and appeals, making it a specialized subset within claims management.

More about Denial Management Analyst jobs
What states have the most Denial Management Analyst jobs? States with the most job openings for Denial Management Analyst jobs include:
What job categories do people searching Denial Management Analyst jobs look for? The top searched job categories for Denial Management Analyst jobs are:
Denial Management Analyst jobs near you
Hospital - Denial Management Analyst

Hospital - Denial Management Analyst

UT Health San Antonio

San Antonio, TX • On-site

Full-time

Posted 8 days ago

UT Health San Antonio rating

7.7

Company rating: 7.7 out of 10

Based on 40 frontline employees who took The Breakroom Quiz

215th of 535 rated colleges and universities

Job description

Job Description
The Denial Management Analyst manages disputed or denied claims by analyzing medical records and payer policies to recover reimbursements in a hospital setting. Reviews and responds to payer audits. Ensures accurate ICD-10 coding, analyzes denial and audit trends to identify root causes, and coordinates appeals through documentation, contract reviews, and payer negotiations. The analyst supports process improvements, tracks appeals, and collaborates with clinical and revenue teams to efficiently review and resolve claim denials. Follows payer-specific rules, federal and state regulations, and industry trends under limited supervision.
Responsibilities
  • Review Denied Claims: Analyze denied insurance claims to determine the root cause of denials and identify corrective actions.
  • Respond to Payer Audits: Prepare and submit required documentation, including medical records, for payer-requested audits and prepayment reviews.
  • Appeal Denials: Develop and submit appeals using medical records, appeal letters, and other supporting documentation to recover denied revenue.
  • Trend Analysis: Analyze denial and audit trends to identify patterns and recommend process improvements to reduce future denials.
  • Verify Coding Accuracy: Work with corresponding departments to ensure proper ICD-10, CPT, and HCPCS codes are applied in the electronic medical record (EMR) and billing systems.
  • Contract Review: Review managed care contracts to verify the appropriate application of reimbursement rates, provisions, and terms.
  • Negotiate Resolutions: Communicate with payers to resolve technical denials and ensure compliance with contract provisions and guidelines.
  • Track Appeals and Outcomes: Maintain detailed records of appeals, their statuses, and outcomes to ensure timely resolution and accurate reporting.
  • Support Process Improvement: Collaborate with clinical denial management and revenue integrity teams to implement strategies that minimize claim denials.
  • Educate Staff: Act as a resource for team members on denial reasons, payer-specific policies, and the appeals process, escalating issues when necessary.
  • Stakeholder Collaboration: act as a liaison between internal departments and external parties (e.g., payers, auditors) to address claim and audit issues.
  • Ensure all work is performed with strict confidentiality while adhering to production and quality goals.
  • Handle high-level appeals, including preparing documentation and negotiating outcomes with insurance companies.
  • Manage escalated claims with significant financial impact, such as underpayments or disputed claims.
  • Conduct root cause analysis on recurring denial issues and recommend solutions.
  • Perform all other duties as assigned by supervisor or manager.

Qualifications
  • Highly detail-oriented with advanced organizational and prioritization skills, capable of managing complex and high-priority projects concurrently.
  • Expert proficiency in Microsoft Word, Excel, PowerPoint, and Outlook
  • Exceptional verbal and written communication skills, including drafting high-level memorandums, letters, and official correspondence.
  • Expert knowledge of hospital billing, appeals processes, and denial management, with the ability to handle complex payer disputes, escalated claims and audits.
  • In-depth understanding of payer contracts, Medicare/Medicaid guidelines, and audit requirements.
  • Strong familiarity with industry best practices in revenue cycle management.
  • Proficient in navigating office software, billing systems, and abstracting tools, with demonstrated expertise in using coding resources.
  • Advanced understanding of insurance authorizations, benefits, coverage, and eligibility as they relate to medical billing.
  • Expertise in reimbursement practices and payer-specific requirements, ensuring compliance and optimal reimbursement.
  • Ability to mentor and guide Tier 1 and Tier 2 billers in billing processes and denial resolutions.
  • Expertise in conducting root cause analysis and providing solutions to recurring billing issues.
  • Stay current on payer-specific guidelines, industry trends, and regulatory requirements to ensure compliance and billing efficiency.

Education:
  • Associate's degree in a related field required

This position may require the ability to maintain the security and integrity of UT San Antonio and its infrastructure per Texas EO-GA-48.

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