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Billing and Denials Analyst

Job Description

• Monitor and analyze billing trends, claim denials, rejection rates, and reimbursement performance.
• Identify patterns and root causes of denials.
• Identify high-dollar denials, recurring denial trends, and claims at risk for timely filing.
• Evaluate denial trends to determine opportunities for prevention, correction, and recovery of revenue.
• Review denied claims, determine appropriate next steps, and identify opportunities for rebilling, appeals, or other resolution.
• Monitor denial-related financial performance and report findings to leadership.
• Develop and maintain dashboards, reports, and tracking tools to monitor billing and denial performance.
• Prepare summaries and recommendations for leadership, revenue cycle committees, and clinic management.
• Compare performance across reporting periods and clinic locations to identify improvement opportunities.
• Develop recommendations for standardized workflows and best practices to prevent avoidable denials.
• Assist with the development of corrective action plans for clinics with elevated denial rates
• Collaborate with providers, clinic leaders, registration staff, prior authorization teams, educators and address denial trends.

Department: Practice Management

Hours: Full time, 40 hours/week

Required: High School Diploma

Pay: Based on experience, starting at $21.62

Responsibilities

Assists with all special projects
and other duties as assigned., Communicate denial trends
and process opportunities to
the Revenue Cycle
Denials/Billing Team., Develops reporting tools that
effectively measure and
monitor processes throughout
the denials management
process in order to support
process improvement., Identifies, analyzes and
researches frequent root
causes of denials and assists
in the development of
corrective action plans for
resolution of denials., Identifies and pursues
opportunities for improvement
in denial performance to
prevent future avoidable
denials., Identifies and pursues
opportunities for improvement
in denial performance to
prevent future avoidable
denials., Researches and analyzes
denial data and coordinates
denial recovery
responsibilities., Runs and disseminates
monthly denial reports to
appropriate areas., Serves as backup for
Credentialing Specialist and
assists with credentialing
projects as needed., Understands and applies
payer coverage,
reimbursement and medical
policies.

Requirements

High School (Required)

Compensation

Estimated Compensation Range

$21.62 - $33.51

Pay based on experience