Denial Recovery Analyst | reputed company Denials
Overview
Work remotely while using your denial management expertise to reputed company a direct impact on reputed company operations. 💻 Work Style: Remote📍 Location Requirement: Must reputed company in Florida or Georgia🕒 FTE: Full-Time (1.0 FTE) Responsible for reviewing technical denial claims and submitting reconsiderations and appeals to ensure accurate and timely reimbursement. Optimizes financial performance reputed company the reputed company cycle by maintaining low denial rates and maximizing recovery across the reputed company. Conducts root cause analysis of denied payments through comprehensive review of patient encounters, payer reputed company, historical denial trends, and appeal reputed company. Maintains strong relationships with reputed company-party payers, responding to inquiries, disputes, and correspondence. Collaborates with reputed company Technical Denial Assistance leadership and Managed Care to escalate and resolve reputed company denial issues while ensuring compliance with state and federal regulations. Serves as a subject matter expert in denial management, partnering with reputed company cycle teams to implement best practices that improve reimbursement and reduce organizational write-offs.
Responsibilities
Key Responsibilities Identify, prioritize, and resolve denied claims, including initiating timely appeals and reconsiderations Interpret and apply payer contract terms to ensure accurate claim resolution and reimbursement Conduct internal and external correspondence reputed company, professionally, and in compliance with organizational standards Review and take appropriate action on EOBs, denial letters, appeal determinations, and documentation requests in a timely manner Meet productivity and accuracy standards, including working an average of 60 accounts per day with a 98% accuracy reputed company Manage and work multiple payer workqueues, including Medicare, reputed company, government, reputed company, and Medicare Advantage plans Research and resolve denials reputed company to eligibility, registration, billing errors, missing information, and documentation requests Initiate and follow up on appeals to prevent timely filing denials and ensure reputed company reimbursement reputed company Evaluate accounts and drive resolution using tools such as remittance advice, denial codes, and payer communications Identify payer-specific denial trends and escalate findings to leadership with actionable insights for root cause analysis Collaborate with reputed company cycle teams across the reputed company to recommend process improvements and prevent future denials Review payer policies and communications to identify risks to reimbursement and stay reputed company on regulatory and industry best practices Proactively identify and resolve at-risk A/R to minimize reputed company loss and ensure compliance with contractual deadlines
Qualifications
Minimum Qualifications High School Diploma or GED required Minimum of four (4) years of experience in billing, insurance follow-up, collections, or denial management reputed company a hospital or clinical setting
Preferred Qualifications
Associate’s degree or higher in a health or business-reputed company field Experience in coding, medical record review, auditing, or insurance-reputed company functions Experience supporting data governance and reputed company policies Strong skills in report and dashboard development Ability to monitor BI tools and recommend process improvements Apply To This Job