DENIAL MANAGEMENT ANALYST

3000 Montefiore Medical Center; New York (NY); On-site; USD 50,000 - 62,000; Full time

Job summary

Montefiore Medical Center in Bronx, NY is seeking a Denials/Appeals Analyst responsible for researching and analyzing insurance denials, identifying root causes, and submitting resubmissions to overturn denials and maximize revenue for the division.

Candidates should have 3-5 years in denial management, knowledge of health plan requirements, and strong skills in EPIC, Excel, Word and PowerPoint; CPC certification and CPT/ICD10 knowledge are preferred. Bachelor's degree preferred.

Qualifications

• Three to five years of progressive experience in appeal/denial management.
• Strong knowledge of health plan requirements.
• Strong analytical, statistical analysis skills.
• Knowledge of CPT coding and ICD-10 diagnosis.
• Experience with EPIC, Excel, Word and PowerPoint.
• Bachelor’s degree preferred; CPC certification preferred.

Responsibilities

• Researches and analyzes denials daily.
• Identifies root causes of denials.
• Processes resubmissions/appeals to overturn denials and maximize revenue.

Skills

Analytical skills

Multi-tasking

Communication skills

Organization

Team collaboration

Research and analysis

Education

Bachelor's degree

Associate's degree

Certified Professional Coder (CPC)

Tools

EPIC Cadence

EPIC HB

EPIC PB

Microsoft Excel

Microsoft Word

PowerPoint

Job description

Job Details

City/State: Bronx, New York

Grant Funded: No

Department: NoMgr

Work Shift: Day

Work Days: MON-FRI

Scheduled Hours: 8:30 AM-5 PM

Scheduled Daily Hours: 7.5 HOURS

Pay Range: $49,920.00-$62,400.00

Responsibilities and Qualifications

Researches and analyzes denials on a daily basis, identifies root causes, and processes resubmissions/appeals with the goal of overturning the denial and getting paid by the insurance carrier, maximizing revenue for the division. Three to five years of progressive experience in appeal/denial management- Preferred Strong knowledge of health plan requirements Strong analytical, statistical analysis skills required. Strong knowledge of EPIC, Microsoft Excel, Word and Power Point skills required Knowledge of federal, regional and state payer coverage patterns (CMS, fiscal intermediary, and Administrative Strong organizational and communication skills; professionalism, able to work with all levels of staff. Bachelor's Degree preferred ( Certified Professional Coder(CPC ) Associate's Degree required (Medical Billing experience) Certified Professional Coder (CPC) required EPIC Cadence, HB, PB certifications preferred Knowledge of CPT coding and ICD10 diagnosis required Ability to work and effectively multi-task in a fast-paced clinic environment with patients with developmental disabilities.

Recruitment Contact

Calling All Nurses! Nurse Recruitment Hotline: [phone]; Monday-Friday: 9am-4pm

About Montefiore

Since its inception in 1884, Montefiore’s mission has been to heal, to teach, to discover and advance the health of the communities we serve. Montefiore's state-of-the-art facilities include the internationally-recognized Children’s Hospital at Montefiore and our Notable Centers of Excellence - Montefiore Einstein Center for Cancer Care, Montefiore Einstein Center for Heart and Vascular Care, Montefiore Einstein Center for Transplantation. Combined with a growing number of locations for primary and specialty care throughout the Bronx and Westchester County, Montefiore is the ideal organization to apply and hone your expertise. An assortment of insurance products and discount programs through Voluntary Benefits. Check out our comprehensive benefits available to you when you join our outstanding team! To heal, to teach, to discover and to advance the health of the communities we serve. To be a premier academic medical center that transforms health and enriches lives.

Equal Employment Opportunity

Montefiore Medical Center is an equal employment opportunity employer. Montefiore Medical Center will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.

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