Denial Management Analyst: Maximize Revenue

Montefiore Health System; New Jersey; On-site; USD 49,920 - 62,400; Full time

Job summary

A prestigious healthcare institution in New Jersey seeks a denial management specialist to research, analyze, and process appeals for denials. The ideal candidate has 3-5 years experience in appeals, strong EPIC and Excel skills, and a CPC certification. This role involves identifying root causes and maximizing revenue through effective communication and analytical skills, ensuring quality care for patients with developmental disabilities. Competitive pay based on experience.

Qualifications

• Three to five years of progressive experience in appeal/denial management is preferred.
• Strong knowledge of health plan requirements is essential.
• Ability to work effectively in a fast-paced clinic environment.

Responsibilities

• Research and analyze denials on a daily basis.
• Identify root causes and process resubmissions/appeals.
• Aim to overturn denials and maximize revenue.

Skills

Analytical skills

Statistical analysis

Organizational skills

Communication skills

Epic knowledge

Microsoft Excel

Knowledge of CPT coding

Knowledge of ICD10 diagnosis

Education

Bachelor's Degree preferred

Certified Professional Coder (CPC)

Associate's Degree required

Tools

EPIC

Microsoft Word

Microsoft PowerPoint

Job description

A prestigious healthcare institution in New Jersey seeks a denial management specialist to research, analyze, and process appeals for denials. The ideal candidate has 3-5 years experience in appeals, strong EPIC and Excel skills, and a CPC certification. This role involves identifying root causes and maximizing revenue through effective communication and analytical skills, ensuring quality care for patients with developmental disabilities. Competitive pay based on experience.