Denials Analyst

Westerkamp Group, LLC; Birmingham (AL); In loco; USD 70.000 - 95.000; Tempo pieno

Descrizione del lavoro

Westerkamp Group, LLC is seeking a Denial Analyst with strong Epic PB experience to lead a team of denial specialists and drive resolutions. You will analyze denials, identify root causes, and implement strategies to prevent recurrences, leveraging Epic Resolute knowledge to optimize workflows and maximize revenue for clients.

The role combines analytical rigor with leadership, requiring excellent communication and a proactive approach to problem-solving within an Accounts Receivable Management

Competenze

• 1+ years of direct experience with Epic PB for operational analysis and workflow optimization.
• Strong understanding of medical coding (CPT, ICD-10, HCPCS) and claim processing.
• Leadership and communication skills with the ability to lead a denial team.

Mansioni

• Identify, analyze, and trend common denial reasons and develop strategies to overturn denials.
• Lead a team of denial specialists and drive resolution of denied claims.
• Analyze Epic workflows to identify root causes and improve configurations.
• Prepare and present reports on denial trends and recovery rates to leadership.

Conoscenze

Leadership

Analytical skills

Communication

Problem-solving

Critical thinking

Formazione

Epic Resolute Certification

Epic Prelude

Epic Cadence

Strumenti

Epic Resolute

Prelude

Cadence

Microsoft Excel

Descrizione del lavoro

Job Description

Westerkamp Group, LLC is an Accounts Receivable Management company focused on hospital and professional billing and collections. We are currently seeking a Denial Analyst. This operational role is ideal for an individual who thrives in a leadership role, possesses exceptional analytical skills, and has a deep understanding of Epic configurations and their impact on the denial lifecycle.

Job Description:

We are seeking a highly motivated and experienced Denial Analyst with a strong background as an Epic Analyst. In this crucial role, you will lead a team of denial specialists, driving the resolution of denied claims, identifying root causes, and implementing strategies to prevent future denials. Your dual expertise in denial management and Epic PB functionality will be critical in optimizing workflows, providing actionable insights, and ensuring maximum revenue capture for our clients.

Key Responsibilities:

• Identify, analyze, and trend common denial reasons (e.g., medical necessity, lack of authorization, coding errors, timely filing, incorrect modifiers).
• Develop and implement strategies to overturn denials and accelerate payment resolution.
• Act as a subject matter expert for Epic Resolute, specifically as it relates to denial prevention and resolution.
• Analyze Epic workflows and configurations to identify root causes of denials stemming from system setup or user error.
• Assist in troubleshooting Epic related issues that lead to denials.
• Develop and maintain denial management policies and procedures.
• Prepare and present regular reports on denial trends, recovery rates, and team performance to RCM leadership and clients.

Required Qualifications:

• 1+ years of direct, hands-on experience as an Epic Professional Billing (PB) Analyst or in a role heavily utilizing Epic PB for operational analysis and workflow optimization.
• Epic Resolute Certification is highly preferred. Additional Epic certifications (e.g., Prelude, Cadence) are a plus.
• Strong understanding of professional medical coding (CPT, ICD-10, HCPCS), claim submission (CMS-1500), and remittance processing (ERA/EOB).
• Exceptional analytical, problem-solving, and critical thinking skills.
• Excellent leadership, communication (verbal and written), and interpersonal skills.
• Proficient in Microsoft Excel (for data analysis and reporting).

Equal Opportunity & Accommodations

Westerkamp Group, LLC, is anEqual Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, gender, national origin, disability, age, veteran status, or any other legally protected status.

If you need a reasonable accommodation during any stage of the application or interview process, please contact [e-mail] or call 985-655-0300.