Denials Management Analyst – Anesthesia

This is a fully remote position, open to applicants in United States.

📋 Description

• Analyzing denial data and establishing payor metrics.

• Monitoring and analyzing denials and results across various systems.

• Identifying and trending root causes, and reporting findings.

• Aiding in the identification of process improvement opportunities.

• Coordinating payor denials and audit activities to ensure timely processing.

• Communicating and collaborating with diverse individuals and groups.

• Overseeing daily operations related to claims denials and audit reviews.

• Managing the healthcare tracking tool/application.

• Supporting the projects and initiatives of the Denials Management Team.

⛳️ Requirements

• Bachelor's degree or an equivalent combination of education and experience.

• 3 years of relevant Anesthesia experience.

• 5-7 years in a Healthcare Revenue Cycle environment, including 3 years in Third Party Collection/AR Receivables and Denials Management.

• Experience with Epic PB Resolute.

• Knowledge of healthcare revenue cycle management, including:

• Therapy (Physical/Occupational/Speech).

• Radiology.

• Pediatrics/Pediatric Orthopedics.

• Anesthesia.

• EDI Transaction sets such as 837I and 837P.

• Understanding of insurance contract rates and terms.

• Knowledge of registration and collections processes.

• Familiarity with government and managed care billing, coverage, and payment regulations.

• Ability to interpret payor 835 and paper EOB responses.

• Understanding of NCCI edits, CPT-4, HCPCS, ICD-10, and Revenue Codes standards.

• Intermediate proficiency in Excel.

• CRCR Certification is preferred.

• Epic Certification is preferred.

🏝️ Benefits

• All employees become eligible for medical coverage from their first day!

• 403(b) and Roth 403(b) Retirement Saving Plan with matching contributions up to 6% after one year of service.

• Paid time off.

• Life insurance.

• Short-term and long-term disability coverage.

• Flexible Spending Account (FSA) options.

• Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is selected.

• Tuition reimbursement.

• Home and auto insurance.

• Hospitalization insurance.

• Critical illness insurance.

• Pet insurance.