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Enterprise Denial Analyst (Remote Florida or Georgia) | Enterprise Denials | Days | Full-Time
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Job Description
- Req#: 41792
Employer Industry: Healthcare Revenue Cycle Management
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to optimize financial outcomes and make a positive impact on the healthcare system
- Engage in root cause analysis to improve denial rates and reimbursement
- Work closely with various departments to resolve denial issues
What to Expect (Job Responsibilities):
- Review technical denial claims and submit reconsiderations or appeals
- Conduct root cause analysis of denied payments through comprehensive research
- Maintain third-party payer relationships by responding to inquiries and complaints
- Collaborate with management to escalate and resolve atypical denial issues
- Ensure compliance with federal and state regulations related to contracts and appeals
What is Required (Qualifications):
- High school graduate required with four (4) years of experience in coding, billing, insurance follow-up, collections, or denial management in a hospital/clinical setting
- Associate's degree or higher in a health or business-related field preferred
- Demonstrated knowledge of hospital billing and reimbursement processes
- Excellent critical thinking, analytical, writing, and communication skills
- Proficient in Microsoft Office products and knowledgeable of HIPAA guidelines
How to Stand Out (Preferred Qualifications):
- Experience in denial management within a hospital or clinical setting
- Strong research and problem-solving skills
- Ability to work independently and manage time effectively
- Familiarity with third-party contracts and federal/state regulations governing the healthcare industry
#HealthcareRevenueCycle #DenialManagement #CareerOpportunity #HealthcareIndustry #ProblemSolvingSkills
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