Denials Management Analyst – Anesthesia

Role Overview

• Analyzing denials data and creating payor metrics
• Tracking and trending denials and results from multiple systems
• Identifying and trending root causes and reporting out findings
• Assisting in mapping out process improvement opportunities
• Coordinating payor denials and audit activities for timely processing
• Communicating and coordinating with various individuals/distributions
• Monitoring day-to-day activities related to claims denials and audit reviews
• Maintaining healthcare tracking tool/application
• Supporting projects and initiatives of the Denials Management Team

Requirements

• Bachelor's degree, or equivalent combination of education and experience
• 3 years of related Anesthesia experience
• 5-7 Years in a Healthcare Revenue Cycle Environment including 3 years in Third Party Collection/AR Receivables and Denials Management
• Epic PB Resolute experience
• Healthcare Revenue Cycle management including:
• Therapy (Physical/Occupational/Speech)
• Radiology
• Pediatrics/Pediatric Orthopedics
• Anesthesia
• EDI Transaction sets including 837I, 837P
• Knowledge of insurance contract rates and terms
• Knowledge and understanding of Registration and Collections
• Knowledge and understanding of Government and Managed Care billing, coverage and payment rules
• Ability to comprehend payor 835 and paper EOB responses
• Knowledge and understanding of NCCI edits, CPT-4, HCPCS, ICD-10 and Revenue Codes standards
• Intermediate Excel skills
• CRCR Certification preferred
• Epic Certification preferred

Benefits

• All employees are eligible for medical coverage on their first day!
• 403(b) and Roth 403 (b) Retirement Saving Plan with matching contributions of up to 6% after one year of service
• Paid time off
• Life insurance
• Short term and long-term disability
• Flexible Spending Account (FSA) plans
• Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is elected
• Tuition reimbursement
• Home & auto insurance
• Hospitalization insurance
• Critical illness insurance
• Pet insurance