Denial Prevention Analyst

maryfreebed; Grand Rapids (MI); On-site; USD 55,000 - 75,000; Full time

Job summary

Mary Free Bed in Grand Rapids, MI, seeks a Billing & Denial Prevention Analyst to ensure accurate, timely, and compliant billing for inpatient and outpatient services. You will monitor claims, address denials, support patient financial engagement, and collaborate with care and revenue teams to optimize reimbursement and reduce risk.

The role emphasizes HIPAA compliance, coordination with payers, and continuous improvement to strengthen cash flow for this not-for-profit rehabilitation hospital.

Responsibilities

• Billing & Claims Management: Submits accurate and timely insurance claims using billing software, ensuring compliance with payer regulations and maximizing reimbursement.
• Denial Prevention & Resolution: Analyzes denial trends, prepares rationales for claim reconsideration, and tracks denial activity to improve cash flow.
• Compliance & Documentation: Ensures HIPAA compliance and reviews clinical notes for completeness to minimize audit risk.
• Patient Financial Engagement: Explains balances, offers payment options, and engages with patients on outstanding balances prior to collections.
• Collaboration & Training: Partners with Access and Patient Services to improve front-end billing accuracy and interdepartmental efficiency.
• Continuous Improvement: Identifies workflow improvements and supports departmental financial goals.

Job description

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

• 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 cus