Clinical Appeals and Denial Analyst

Infirmary Health; Mobile (AL); On-site; USD 42,000 - 66,000; Full time

Job summary

Infirmary Health seeks a Denials Analyst to support timely responses to clinical denials and audit findings, ensuring documentation standards and effective communication with payors. The role focuses on revenue cycle improvement, compliance, and minimizing revenue loss through thorough analysis and cross-functional collaboration with internal stakeholders.

Experience in healthcare billing is preferred; responsibilities include maintaining audit trails, preparing data for appeals, and assisting

Qualifications

• Minimum qualifications include a bachelor’s degree in business administration or healthcare administration, or 4 of the most recent 6 years’ experience in healthcare insurance or billing.
• Excellent organizational and communication skills; ability to manage multiple tasks.

Responsibilities

• Ensures timely and effective responses to clinical denials and audit findings, supporting the appeals process by providing analytical insight, maintaining documentation standards, and facilitating communication between internal stakeholders and external payors.
• Helps ensure compliance, reduce revenue loss, and improve outcomes related to governmental and commercial audits.

Skills

Revenue cycle basics

Oral and written communication

Multitasking

PC skills (Word, Excel, data entry)

Documentation standards

Education

Bachelor's degree in business administration

Bachelor's degree in healthcare administration

4 of the most recent 6 years’ experience in healthcare insurance or billing

Tools

Midas report writing software

Job description

Responsibilities

Ensures timely and effective responses to clinical denials and audit findings, supporting the appeals process by providing analytical insight, maintaining documentation standards, and facilitating communication between internal stakeholders and external payors. The role helps ensure compliance, reduce revenue loss, and improve outcomes related to governmental and commercial audits.

Qualifications

Minimum Qualifications

One of the following:

• Bachelor’s degree in business administration
• Bachelor’s degree in healthcare administration
• 4 of the most recent 6 years’ experience working in healthcare insurance or billing

Also:

• Basic knowledge of the revenue cycle (e.g. billing, reimbursement)
• Strong oral and written communication skills
• Excellent organizational skills and attention to detail
• Ability to manage multiple tasks simultaneously
• Proficiency in personal computer use, including word processing, spreadsheets, data entry, email, scanning, and Adobe applications

Desired Qualifications

• Working knowledge of Midas report writing software