Denial Prevention Analyst

Mary Free Bed Rehabilitation Hospital; Grand Rapids (MI); On-site; USD 25,000 - 33,000; Full time

Job summary

Mary Free Bed Rehabilitation Hospital in Grand Rapids, MI is seeking a Billing & Denial Prevention Analyst to ensure accurate, timely billing for inpatient and outpatient services. You will navigate payer regulations, monitor denials, and optimize reimbursement while supporting financial health.

The role emphasizes cross-department collaboration, adherence to HIPAA, and effective patient financial engagement.

Qualifications

• Associate degree or equivalent experience in healthcare administration.
• 3+ years of progressive experience in healthcare billing.
• General experience with CPT coding and third-party billing requirements.
• Proficient in Microsoft Excel for data tracking and reporting.
• Strong written and verbal communication skills.

Responsibilities

• Submit accurate and timely insurance claims using billing software.
• Follow up on unpaid claims and interpret denial reasons.
• Process insurance rejections and request additional information as needed.
• Analyze denial trends and suggest process improvements.
• Prepare and submit rationales for claim reconsideration to improve overturn rates.
• Track denial activity to support data-driven decisions.
• Ensure HIPAA compliance and accurate documentation.
• Explain patient balances and options to support financial counseling.
• Collaborate with Access and Patient Services to improve front-end accuracy.

Skills

CPT coding

Third-party billing

Analytical thinking

Communication skills

Excel

Education

Associate degree in healthcare administration

Tools

Excel

Job description

Mary Free Bed SummaryWe 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 careMission StatementRestoring hope and freedom through rehabilitation.Employment Value PropositionAt Mary Free Bed, we take pride in our values-based culture: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.SummaryThe 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 ResponsibilitiesBilling & Claims ManagementSubmits 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 & ResolutionAnalyzes 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 & DocumentationEnsures 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 EngagementSupports 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 & TrainingPartners 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 ImprovementIdentifies workflow efficiencies and participate in process redesigns to support departmental financial goals.Contributes to team success by performing other duties as assigned.Customer Service ResponsibilitiesDemonstrate 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 ImprovementContribute by identifying problems and seeking solutions. Promote patient/family satisfaction where possible; participates in departmental efforts to monitor and report customer service.Essential Job QualificationsAssociate degree or equivalent experience in healthcare administration with at least 3 years of progressive experience in healthcare billing.General experience with CPT coding and 3rd party billing requirements.Requires analytical and communication skills necessary to explain, interpret, and present data.Strong organizational and time management skills with the ability to manage multiple priorities and meet deadlines.Demonstrated ability to work collaboratively across departments and with external payors.Strong written and verbal communication skills for preparing appeals and interacting with patients and payors.Skilled in Microsoft Office Suite, especially Excel for data tracking and reporting.Empathetic and professional approach to patient financial counseling and inquiries.Preferred Job QualificationsCertification as Certified Professional Coder (CSC), Certified Coding Specialist-Professional (CCS-P), or Certified Medical Reimbursement Specialist (CMRS).Three to five years’ experience working with rehabilitation hospitals, inpatient/outpatient billing or specialty care is a plus.Physical Requirements for Essential Job QualificationLevels :None (No specific requirements)Occasionally (Less than 1/3)Frequently (1/3 to 2/3)Majority (More than 2/3)Remain in a stationary position: MajorityTraverse or move around work location: NoneUse keyboard: FrequentlyOperate or use department specific equipment: NoneAscend/Descend equipment or ladder: NonePosition self to accomplish the Essential Functions of the role: NoneReceive and communicate information and ideas for understanding: MajorityTransport, position, and/or exert force:Up to 10 pounds: OccasionallyUp to 25 pounds:NoneUp to 50 pounds: NoneUp to 75 pounds: NoneMore than 100 pounds:NoneOther weight: Up to___ poundsNone Other: NoneConsistent with the Americans with Disabilities Act (ADA), it is the policy of Mary Free Bed Rehabilitation Hospital to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Talent Acquisition team at [e-mail] .Mary Free Bed is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, genetic information, veteran status, disability or other legally protected characteristic.Compensation based on experience, starting from $20.94.