Billing & Denial Prevention Analyst

Mary Free Bed Rehabilitation; Grand Rapids (MI); On-site; USD 24,000 - 34,000; Full time

Job summary

Mary Free Bed Rehabilitation in Grand Rapids, MI is seeking a Billing & Denial Prevention Analyst to ensure accurate, timely, and compliant billing for inpatient and outpatient services. You will monitor insurer denials, analyze trends, prepare rationales for appeals, and collaborate with Access, Patient Services, Revenue Cycle, and clinical teams to improve cash flow.

The role emphasizes HIPAA compliance, patient financial counseling, and continuous improvement in billing processes within our

Qualifications

• Associate degree or equivalent experience in healthcare administration with at least 3 years of progressive experience in healthcare billing.
• General experience with CPT coding and 3rd party billing requirements.
• Requires analytical and communication skills necessary to explain, interpret, and present data.
• Strong organizational and time management skills with the ability to manage multiple priorities and meet deadlines.
• Demonstrated ability to work collaboratively across departments and with external payors.
• Strong written and verbal communication skills for preparing appeals and interacting with patients and payors.
• Skilled in Microsoft Office Suite, especially Excel for data tracking and reporting.
• Empathetic and professional approach to patient financial counseling and inquiries.

Responsibilities

• Submits accurate and timely insurance claims using billing software, ensuring compliance with payer regulations and maximizing reimbursement.
• Monitors and follows up on unpaid claims, interpreting denial reasons, identifying root causes, and navigating the appeals process with appropriate documentation.
• Processes insurance rejections and requests for additional information (e.g., medical records, invoices) to expedite resolution and payment.
• Analyzes denial trends to identify systemic issues and recommend process improvements to leadership.
• Prepares and submits written rationales for claim reconsideration requests to improve overturn rates and strengthen cash flow.
• Tracks and reports denial activity in centralized systems to support data-driven decision-making.
• Ensures adherence to HIPAA and all payer/governmental regulations to protect patient privacy and organizational compliance.
• Reviews clinician notes and clinical documentation for completeness and accuracy to support compliant billing and minimize audit risk.
• Researches and communicates changes in billing regulations to leadership, ensuring ongoing compliance and reducing denial exposure.
• Supports patients by explaining balances, offering payment options, and connecting them with financial assistance programs.
• Engages with patients on outstanding balances prior to collections, promoting transparency and reducing bad debt risk.
• Responds to patient inquiries via phone and email with professionalism and empathy.
• Partners with Access and Patient Services teams to identify training needs and improve front-end billing accuracy.
• Collaborates across Revenue Cycle and clinical departments to resolve claim issues and enhance interdepartmental efficiency.
• Develops and maintains strategic relationships with key payers to reduce AR days and improve revenue cycle performance.
• Identifies workflow efficiencies and participate in process redesigns to support departmental financial goals.
• Contributes to team success by performing other duties as assigned.

Skills

Analytical skills

Communication skills

Organizational skills

Time management

Team collaboration

Patient financial counseling

Excel proficiency

Attention to detail

Education

Associate degree in healthcare administration

3+ years in healthcare billing

Tools

Microsoft Excel

Job description

About Orthotics & Prosthetics + Bionics

It's Different Here: Access Patient Service Representative

Mary Free Bed Summary

We have the great privilege of helping patients and families re-build their lives. It's extraordinarily meaningful work and the reason we greet the day with optimism and anticipation. When patients "Ask for Mary," they experience a culture that has been sculpted for more than a century. Our hallmark is to carefully listen to patients and innovatively serve them. This is true of every employee, from support staff and leadership, to clinicians and care providers.

Mary Free Bed is a not-for-profit, nationally accredited rehabilitation hospital serving thousands of children and adults each year through inpatient, outpatient, sub-acute rehabilitation, orthotics and prosthetics and home and community programs. With the most comprehensive rehabilitation services in Michigan and an exclusive focus on rehabilitation, Mary Free Bed physicians, nurses and therapists help our patients achieve outstanding clinical outcomes.The growing Mary Free Bed Network provides patients throughout the system with access to our unique standard of care

Mission Statement

Restoring hope and freedom through rehabilitation.

Employment Value Proposition

At Mary Free Bed, we take pride in our values-based culture:

• Focus on Patient Care. A selfless drive to serve and heal connects all MFB employees.
• Clinical Variety and Challenge. An inter-disciplinary approach and a top team of professionals create ever-changing opportunities and activities.
• Family Culture. We offer the stability of a large organization while nurturing the family/team atmosphere of a small organization.
• Trust in Each Other. Each employee knows that co-workers can be trusted to make the right decision for our family, patients, staff, and community.
• A Proud Tradition. Years of dedicated, quality service to our patients and community have yielded a reputation that fills our employees with pride.

Summary

The Billing & Denial Prevention Analyst plays a critical role in ensuring accurate, timely, and compliant billing for inpatient and outpatient services. This position requires deep knowledge of payer regulations and billing practices to optimize reimbursement, reduce denials, and support the financial health of the organization.

Essential Job Responsibilities

Billing & Claims Management

• Submits accurate and timely insurance claims using billing software, ensuring compliance with payer regulations and maximizing reimbursement.
• Monitors and follows up on unpaid claims, interpreting denial reasons, identifying root causes, and navigating the appeals process with appropriate documentation.
• Processes insurance rejections and requests for additional information (e.g., medical records, invoices) to expedite resolution and payment.

Denial Prevention & Resolution

• Analyzes denial trends to identify systemic issues and recommend process improvements to leadership.
• Prepares and submits written rationales for claim reconsideration requests to improve overturn rates and strengthen cash flow.
• Tracks and reports denial activity in centralized systems to support data-driven decision-making.

Compliance & Documentation

• Ensures adherence to HIPAA and all payer/governmental regulations to protect patient privacy and organizational compliance.
• Reviews clinician notes and clinical documentation for completeness and accuracy to support compliant billing and minimize audit risk.
• Researches and communicates changes in billing regulations to leadership, ensuring ongoing compliance and reducing denial exposure.

Patient Financial Engagement

• Supports patients by explaining balances, offering payment options, and connecting them with financial assistance programs.
• Engages with patients on outstanding balances prior to collections, promoting transparency and reducing bad debt risk.
• Responds to patient inquiries via phone and email with professionalism and empathy.

Collaboration & Training

• Partners with Access and Patient Services teams to identify training needs and improve front-end billing accuracy.
• Collaborates across Revenue Cycle and clinical departments to resolve claim issues and enhance interdepartmental efficiency.
• Develops and maintains strategic relationships with key payers to reduce AR days and improve revenue cycle performance.

Continuous Improvement

• Identifies workflow efficiencies and participate in process redesigns to support departmental financial goals.
• Contributes to team success by performing other duties as assigned.

Customer Service Responsibilities

Demonstrate excellent customer service and standards of behaviors as well as encourages, coaches, and monitors the same in team members. This individual should consistently promote teamwork and direct communication with co-workers and deal discretely and sensitively with confidential information.

Responsibilities in Quality Improvement

Contribute by identifying problems and seeking solutions. Promote patient/family satisfaction where possible; participates in departmental efforts to monitor and report customer service.

Essential Job Qualifications

• Associate degree or equivalent experience in healthcare administration with at least 3 years of progressive experience in healthcare billing.
• General experience with CPT coding and 3rd party billing requirements.
• Requires analytical and communication skills necessary to explain, interpret, and present data.
• Strong organizational and time management skills with the ability to manage multiple priorities and meet deadlines.
• Demonstrated ability to work collaboratively across departments and with external payors.
• Strong written and verbal communication skills for preparing appeals and interacting with patients and payors.
• Skilled in Microsoft Office Suite, especially Excel for data tracking and reporting.
• Empathetic and professional approach to patient financial counseling and inquiries.

Preferred Job Qualifications

• Certification as Certified Professional Coder (CSC), Certified Coding Specialist-Professional (CCS-P), or Certified Medical Reimbursement Specialist (CMRS).
• Three to five years' experience working with rehabilitation hospitals, inpatient/outpatient billing or specialty care is a plus.

Physical Requirements for Essential Job Qualification

Levels

• None (No specific requirements)
• Occasionally (Less than 1/3)
• Frequently (1/3 to 2/3)
• Majority (More than 2/3)

Remain in a stationary position: Majority

Traverse or move around work location: None

Use keyboard: Frequently

Operate or use department specific equipment: None

Ascend/Descend equipment or ladder: None

Position self to accomplish the Essential Functions of the role: None

Receive and communicate information and ideas for understanding: Majority

Transport, position, and/or exert force:

Up to 10 pounds: Occasionally

Up to 25 pounds: None

Up to 50 pounds: None

Up to 75 pounds: None

More than 100 pounds: None

Other weight: Up to___ pounds None

Other: None

Compensation based on experience, starting from $20.94.

Mary Free Bed is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, genetic information, veteran status, disability or other legally protected characteristic.