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.
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.
Hospital - Denial Management Analyst
San Antonio, TX · On-site +1
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.
Hospital - Denial Management Analyst
San Antonio, TX · On-site +1
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.
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 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
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
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
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
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 ...
Quick apply
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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AR & Denial Management
Richardson, TX · On-site
$19 - $22/hr
The AR Follow-up & Denial Management Specialist is responsible for the timely resolution of unpaid ... Analyze denial trends, identify root causes, and implement corrective actions * Correct claims and ...
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AR & Denial Management
Richardson, TX · On-site
$19 - $22/hr
The AR Follow-up & Denial Management Specialist is responsible for the timely resolution of unpaid ... Analyze denial trends, identify root causes, and implement corrective actions * Correct claims and ...
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AR & Denial Management
Richardson, TX · On-site
$19 - $22/hr
The AR Follow-up & Denial Management Specialist is responsible for the timely resolution of unpaid ... Analyze denial trends, identify root causes, and implement corrective actions * Correct claims and ...
Quick apply
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AR & Denial Management
Richardson, TX · On-site
$19 - $22/hr
The AR Follow-up & Denial Management Specialist is responsible for the timely resolution of unpaid ... Analyze denial trends, identify root causes, and implement corrective actions * Correct claims and ...
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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 ...
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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 ...
Drive Denial Resolution. Make a Local Impact. Westerkamp Group, LLC is a Birmingham-based Revenue ... We're currently hiring a Senior Denials Management Analyst to support a fast-growing hospital ...
Drive Denial Resolution. Make a Local Impact. Westerkamp Group, LLC is a Birmingham-based Revenue ... We're currently hiring a Senior Denials Management Analyst to support a fast-growing hospital ...
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 ...
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 ...
Denial Management Specialist
Grand Forks, ND · On-site
$17.07 - $25.60/hr
The position involves monitoring RAC accounts for adjustments, analyzing denial trends, and ... Manages and file appeals to reverse denials wherever possible. * Works on assigned denials and ...
Denial Management Specialist
Grand Forks, ND · On-site
$17.07 - $25.60/hr
The position involves monitoring RAC accounts for adjustments, analyzing denial trends, and ... Manages and file appeals to reverse denials wherever possible. * Works on assigned denials and ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Initiates a root cause analysis of denied payment through comprehensive means including but not ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Initiates a root cause analysis of denied payment through comprehensive means including but not ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Initiates a root cause analysis of denied payment through comprehensive means including but not ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Initiates a root cause analysis of denied payment through comprehensive means including but not ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Initiates a root cause analysis of denied payment through comprehensive means including, but not ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Initiates a root cause analysis of denied payment through comprehensive means including, but not ...
Medical-Denial Management Specialist
Farmington, CT · On-site
$19.25 - $25/hr
Our growing practice is currently seeking a Medical-Denial Management Specialist with Epic ... Thís role requires strong analytical, communication, and problem-solving skills, along with a ...
Medical-Denial Management Specialist
Farmington, CT · On-site
$19.25 - $25/hr
Our growing practice is currently seeking a Medical-Denial Management Specialist with Epic ... Thís role requires strong analytical, communication, and problem-solving skills, along with a ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Initiates a root cause analysis of denied payment through comprehensive means including, but not ...
Overview Work remotely while using your denial management expertise to make a direct impact on ... Initiates a root cause analysis of denied payment through comprehensive means including, but not ...
Medical-Denial Management Specialist
Farmington, CT · On-site
$19.25 - $25/hr
Our growing practice is currently seeking a Medical-Denial Management Specialist with Epic ... Thís role requires strong analytical, communication, and problem-solving skills, along with a ...
Medical-Denial Management Specialist
Farmington, CT · On-site
$19.25 - $25/hr
Our growing practice is currently seeking a Medical-Denial Management Specialist with Epic ... Thís role requires strong analytical, communication, and problem-solving skills, along with a ...
Denial Management Analyst information
See salary details
$43K - $51.1K
8% of jobs
$51.1K - $59.2K
12% of jobs
$63.4K is the 25th percentile. Wages below this are outliers.
$59.2K - $67.3K
11% of jobs
$67.3K - $75.4K
14% of jobs
The median wage is $79.8K / yr.
$75.4K - $83.5K
11% of jobs
$83.5K - $91.5K
12% of jobs
$97.8K is the 75th percentile. Wages above this are outliers.
$91.5K - $99.6K
11% of jobs
$99.6K - $107.7K
5% of jobs
$107.7K - $115.8K
11% of jobs
$115.8K - $123.9K
5% of jobs
$123.9K - $132K
1% of jobs
$43K
$85K
$132K
How much do denial management analyst jobs pay per year?
What are the key skills and qualifications needed to thrive as a denial management analyst, and why are they important?
What are some common challenges faced by denial management analysts, and how can they be addressed?
What does a denial management analyst do?
What is the difference between Denial Management Analyst vs Claims Analyst?
| Aspect | Denial Management Analyst | Claims Analyst |
|---|---|---|
| Credentials | Typically requires a healthcare or insurance-related certification, such as CPC or CCS | Often requires a healthcare administration or insurance certification, like CPC or similar |
| Work Environment | Works primarily in healthcare billing departments, insurance companies, or hospital revenue cycles | Works in insurance companies, healthcare providers, or third-party administrators |
| Industry Usage | Commonly employed in healthcare revenue cycle management to address claim denials | Used 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.

Full-time
Re-posted 11 days ago
UT Health San Antonio rating
7.2
Based on 43 frontline employees who took The Breakroom Quiz
382nd of 617 rated colleges and universities
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: Associates degree is required.
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About UT Health San Antonio
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Industry
Colleges, universities, and professional schools
Company size
5,001 - 10,000 Employees
Headquarters location
San Antonio, TX, US
Year founded
1959