DENIAL MANAGEMENT ANALYST (225542)

ViziRecruiter,LLC.; New York (NY); On-site; USD 49,920 - 62,400; Full time

Job summary

A healthcare organization in Bronx, NY is looking for a denial management specialist to research and analyze denials and optimize revenue collection. Ideal candidates will have 3-5 years of experience in healthcare appeals, strong analytical skills, and knowledge of coding standards. A Bachelor's Degree is preferred alongside a Certified Professional Coder (CPC) certification. This position offers a competitive salary range of $49,920.00-$62,400.00.

Qualifications

• Three to five years of experience in appeal/denial management.
• Strong knowledge of health plan requirements.
• Knowledge of CPT coding and ICD10 diagnosis required.

Responsibilities

• Researches and analyzes denials on a daily basis.
• Identifies root causes of denials.
• Processes resubmissions and appeals to maximize revenue.

Skills

Analytical skills

Statistical analysis

EPIC knowledge

Microsoft Excel

Communication skills

Education

Bachelor's Degree (preferred)

Associate Degree (required)

Certified Professional Coder (CPC)

Tools

Microsoft Word

Microsoft PowerPoint

Job description

Introduction

To heal, to teach, to discover and to advance the health of the communities we serve.

To learn more about the “Montefiore Difference” – who we are at Montefiore and all that we have to offer our associates, please click here.

Overview

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

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.

Requirements

• 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 PowerPoint 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 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.