Denial Analyst - Hospital Billing (Remote)

Revenue Cycle Denial Analyst

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. The Revenue Cycle Denial Analyst is charged with coordinating the analysis and effective resolution of denied claims with the purpose of reducing overall denials and increasing revenue. This includes interpreting payment and denial data down to the line item detail, identifying payer and coding trends, risks, and opportunities, to implement operational or systematic improvements. Essential to this position are strong quantitative, analytical and organizational skills. Excellent communication and interpersonal skills with the ability to effectively interpret, communicate, and educate others.

Essential Responsibilities :

• Responsible for prioritizing and managing to resolution denied claims with third party payers.
• Research, develop and maintain a solid understanding of payer requirements, including filing limit, claim processing logic, coordination of benefits requirements, patient responsibility and authorization requirements.
• Ability to triage denied claims to identify those that should be appealed.
• Responsible for writing timely, comprehensive and compelling appeals to third party payers in order to get denial overturned.
• Responsible for timely follow up on filed appeals via telephone, writing, or the payer website.
• Organizes, maintains and updates the access payer database to house the issues that need to be addressed with third party insurers, as well as maintaining an expert knowledge of the history of prior disputes and problems to prevent them from recurrence.
• Applies findings to internal systems and workflows such as pre-billing edits and system automation.
• Performs ongoing analysis to determine the root cause of denials and makes well thought out recommendations for workflow, operations or systemic changes.
• Maintains action plans for improvements.
• Compiles, maintains and distributes reports to management on success of appeals and root cause analysis.
• Serves as department resource related to denials and payer requirements.

Required Qualifications :

Preferred Qualifications :

Competencies :

Pay Range : $52,749.00 USD - $70,993.00 USD The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer / Veterans / Disabled