Billing and Denials Analyst

Sarah Bush Lincoln; Oregon; Hybrid; USD 30,000 - 46,000; Full time

Job summary

Sarah Bush Lincoln is seeking a Billing and Denials Analyst to monitor and analyze claims, trends, and denial patterns within the revenue cycle. The role involves identifying root causes, prioritizing high-dollar denials, and guiding recovery of revenue through preventive actions and targeted appeals.

You will develop dashboards, prepare leadership summaries, and collaborate with clinics and clinicians to implement standardized denial workflows.

Qualifications

• Experience analyzing billing trends and denials in a health care revenue cycle.
• Ability to identify root causes of denials and opportunities for improvement.
• Proficient in creating dashboards and reports to monitor performance.

Responsibilities

• Monitor and analyze billing trends, denial rates, and reimbursement performance.
• Identify patterns and root causes of denials.
• Identify high-dollar denials and at-risk claims for timely filing.
• Evaluate denial trends to guide prevention and recovery of revenue.
• Review denied claims and determine next steps for rebilling or appeals.
• Develop dashboards and reporting tools to track denial performance.
• Prepare summaries and recommendations for leadership and clinics.

Skills

Billing analysis

Denials analysis

Root cause analysis

Data reporting

Education

High School Diploma

Tools

Excel

Dashboarding

Job description

Billing and Denials AnalystJob 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 ManagementHours: Full time, 40 hours/weekRequired: High School DiplomaPay: Based on experience, starting at $21.62Responsibilities Assists with all special projectsand other duties as assigned., Communicate denial trendsand process opportunities tothe Revenue CycleDenials/Billing Team., Develops reporting tools thateffectively measure andmonitor processes throughoutthe denials managementprocess in order to supportprocess improvement., Identifies, analyzes andresearches frequent rootcauses of denials and assistsin the development ofcorrective action plans forresolution of denials., Identifies and pursuesopportunities for improvementin denial performance toprevent future avoidabledenials., Identifies and pursuesopportunities for improvementin denial performance toprevent future avoidabledenials., Researches and analyzesdenial data and coordinatesdenial recoveryresponsibilities., Runs and disseminatesmonthly denial reports toappropriate areas., Serves as backup forCredentialing Specialist andassists with credentialingprojects as needed., Understands and appliespayer coverage,reimbursement and medicalpolicies.Requirements High School (Required)CompensationEstimated Compensation Range $21.62 - $33.51Pay based on experience