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Remote Denial Analyst Jobs in Spring Valley, CA (NOW HIRING)

Deloitte

Epic Denials Management Operator

San Diego, CA · Remote

$19 - $25.50/hr

Conduct Denial categorization and root cause analysis based on remittance information received from ... This is a primarily remote role supporting enterprise Epic support, with minimal travel and ...

Plaza Home Mortgage, Inc.

Sr. Underwriter

San Diego, CA · Remote

$40.86 - $50.48/hr

This position is responsible for analyzing and evaluating consumer home loan applications as well ... Must be able to recommend approval or denial of credit applications, and provide written and verbal ...

All JobsDenial Analyst JobsRemote Denial Analyst JobsRemote Denial Analyst Jobs in Spring Valley, CA

Remote Denial Analyst information

What is a remote denial analyst?

Remote Denial Analysts are professionals who review and analyze denied insurance claims from a remote location. Their primary responsibility is to identify the reasons for claim denials, gather necessary documentation, and communicate with insurance companies to resolve issues. They work with healthcare providers, billing departments, and payers to ensure that claims are processed correctly and payments are obtained. Remote Denial Analysts play a crucial role in improving the financial performance of healthcare organizations by minimizing lost revenue due to denied claims.

What skills and qualifications are needed to thrive as a remote denial analyst?

To thrive as a Remote Denial Analyst, you need a solid understanding of medical billing, insurance claims processes, and healthcare regulations, typically with experience in revenue cycle management or a related field. Familiarity with electronic health record (EHR) systems, claims management software, and knowledge of ICD-10/CPT coding are essential, and certifications like Certified Professional Coder (CPC) can be advantageous. Strong analytical thinking, attention to detail, and effective communication skills help you investigate claim denials and collaborate with providers and payers. These abilities are crucial for maximizing reimbursement, reducing claim denials, and supporting the financial health of healthcare organizations.

What are common challenges faced by remote denial analysts and how can they be managed?

Remote Denial Analysts often encounter challenges such as incomplete documentation, unclear denial reasons, and delays in obtaining additional information from providers or payers. Managing these challenges requires strong analytical skills, attention to detail, and effective communication with both internal teams and external stakeholders. Proactive follow-up, staying updated on payer policies, and leveraging denial management software can help streamline the process and improve resolution rates, even when working remotely.

What is the difference between Remote Denial Analyst vs Remote Claims Processor?

AspectRemote Denial AnalystRemote Claims Processor
Primary RoleReview and analyze insurance claim denials to determine validity and suggest resolutions.Process and review insurance claims for accuracy, completeness, and approval.
Required CredentialsKnowledge of insurance policies, claims processing, and denial reasons; certifications like CPC or CPC-H are common.Basic understanding of insurance claims; certifications are often similar but less specialized.
Work EnvironmentRemote, often in healthcare or insurance companies, focusing on claims review.Remote or office-based, handling claims data and customer interactions.

While both roles involve insurance claims, the Remote Denial Analyst specializes in reviewing denied claims to identify issues, whereas the Remote Claims Processor handles the overall processing and approval of claims. The Denial Analyst requires more expertise in denial reasons and related certifications, making it a more analytical role focused on resolution.

What job categories do people searching Remote Denial Analyst jobs in Spring Valley, CA look for?

The top searched job categories for Remote Denial Analyst jobs in Spring Valley, CA are:

What cities near Spring Valley, CA are hiring for Remote Denial Analyst jobs?

Cities near Spring Valley, CA with the most Remote Denial Analyst job openings:

Remote Denial Analyst jobs near you

Epic Certified HB Analyst - Home Health - Remote - San Diego, CA

Waterfall Technology Consulting Partners

San Diego, CA • Remote

$126K - $136K/yr

Full-time

Re-posted 17 days ago

Job description

We are partnered with a wonderful organization seeking an experienced Epic HB Home Health Billing Analyst to support the ongoing optimization, maintenance, and enhancement of Epic revenue cycle workflows related to Home Health services. The ideal candidate will possess an active Epic Hospital Billing (HB) certification and demonstrate hands-on experience supporting Home Health billing, charge capture, claims processing, reimbursement, and revenue cycle operations within Epic.

This is a remote, long-term, two-year engagement supporting a healthcare organization's Epic environment. The role is salaried only.  

Must be available to work Pacific Time (West Coast) business hours and participate in a rotating on-call support schedule.

What will I be doing?

  • Provide application support, build, maintenance, and optimization for Epic HB and Home Health billing workflows
  • Analyze, design, configure, test, implement, and support Epic HB solutions related to Home Health services
  • Collaborate with revenue cycle leaders, operational stakeholders, and end users to gather requirements and recommend system improvements
  • Troubleshoot production issues and perform root cause analysis to resolve billing and reimbursement challenges
  • Support claims processing, charge review, reimbursement workflows, and billing-related system configurations
  • Participate in system upgrades, enhancements, integrated testing, and new feature implementations
  • Develop and maintain application documentation, workflow diagrams, build specifications, and testing scripts
  • Assist with optimization initiatives designed to improve revenue cycle performance and end-user experience
  • Work closely with technical, operational, and clinical teams to ensure successful project execution

What requirements do I need?

  • Active Epic Hospital Billing (HB) Certification
  • Demonstrated experience supporting Home Health billing workflows within Epic
  • Minimum of 2 years of Epic HB analyst experience
  • Strong understanding of healthcare revenue cycle operations, reimbursement, claims management, and billing processes
  • Experience with Epic build, testing, implementation, and production support
  • Ability to troubleshoot complex application and workflow issues
  • Strong communication, organizational, and customer service skills
  • Ability to work independently in a remote environment while effectively collaborating with cross-functional teams

Preferred Qualifications

  • Experience supporting Home Health organizations or post-acute care environments
  • Experience with Epic revenue cycle optimization initiatives
  • Familiarity with charge router, claim edits, reimbursement workflows, and denial management
  • Experience supporting Epic upgrades and large-scale implementations
  • Additional Epic certifications are a plus

Education

  • Bachelor's degree in Healthcare, Information Technology, Business, or related field preferred
  • Equivalent combination of education and relevant Epic experience will be considered

This role is ideal for an Epic-certified analyst who has a strong foundation in Hospital Billing and Home Health revenue cycle workflows and is looking to contribute to a long-term healthcare technology initiative.

If you have the skills required for this role, we want to speak to you.

Apply today!