Denials Analyst

Insight Global (United States); Torrance (CA); On-site; USD 90,000 - 110,000; Full time

Benefits offered by this job

Health insurance

Job summary

Insight Global is seeking a Senior Revenue Cycle Denials Analyst to support hospital revenue cycle operations. You will analyze facility claim denials, identify payer trends, perform root-cause analysis, and guide a small team of collectors.

This is an onsite, non-exempt role with a Monday–Friday schedule roughly 7:00 a.m. to 4:00 p.m., reporting to revenue cycle leadership and collaborating with clinical and HIM teams.

Qualifications

• 5+ years in hospital denials, collections, or appeals.
• Strong knowledge of hospital denials including authorization, COB, and medical necessity.
• Advanced Excel skills for dashboards and trend analysis.
• Leadership experience supervising a small team.

Responsibilities

• Analyze hospital denials to identify root causes and payer trends.
• Review EOBs, ERA, payer responses to determine resolution steps.
• Evaluate denials by authorization, COB, medical necessity, and coding.
• Decide when to correct, rebill, appeal, or escalate.
• Create Excel reports and dashboards showing denial trends.
• Present findings to revenue cycle leadership.
• Manage a team of about three collectors and ensure quality.

Skills

Advanced Excel

Leadership

Root-cause analysis

Revenue cycle

Denials management

Education

Associate degree or higher

Tools

Cerner

Epic

UB-04 knowledge

ICD-10-CM/CPT/HCPCS

Job description

Job Description

Insight Global is seeking a Senior Revenue Cycle Denials Analyst to support hospital revenue cycle operations. This individual will analyze facility claim denials, identify payer and operational trends, perform root-cause analysis, and recommend denial-prevention strategies. The analyst will also provide guidance and oversight to approximately three collectors and report findings directly to revenue cycle leadership.

This is a direct-hire, non-exempt position that is fully onsite, Monday through Friday, with scheduling flexibility around 7:00 a.m. to 4:00 p.m.

Day-to-Day Responsibilities

• -Analyze hospital and facility claim denials to identify root causes, recurring patterns, payer trends, and operational barriers.
• -Review EOBs, ERAs, payer correspondence, claims, account documentation, and authorization information to determine appropriate resolution steps.
• -Evaluate authorization, COB, medical necessity, inpatient versus outpatient, partial authorization, coding/documentation, and payer-specific denials.
• -Determine whether accounts require correction, rebilling, appeal, payer escalation, or referral to clinical, Utilization Management, Coding, or other internal resources.
• -Distinguish between claim denials and underpayments and identify the appropriate follow-up process.
• -Create and maintain Excel reports, dashboards, and spreadsheets that communicate denial trends, root causes, recovery activity, and recommended solutions.
• -Develop denial-prevention recommendations rather than focusing solely on resolving individual accounts.
• -Work with Patient Access, Case Management, HIM, Coding, Revenue Integrity, Managed Care, and clinical teams to address recurring denial causes.
• -Oversee approximately three collectors, monitor productivity and quality, provide technical guidance, and assist with difficult accounts.
• -Present denial trends, barriers, and process-improvement recommendations to revenue cycle leadership.
• -Maintain accurate account documentation and meet payer-specific appeal and timely-filing deadlines.

Skills and Requirements

• -5+ years of relevant hospital or facility revenue cycle experience, preferably in collections, denials, appeals, or accounts receivable. Extensive relevant experience may be considered in lieu of a degree.
• -Strong hospital/facility billing experience. Candidates with only physician or professional billing experience will not be considered.
• -Deep knowledge of hospital denials, including authorization, COB, medical necessity, inpatient/outpatient, partial authorization, EOB/remittance, and payer-specific denials.
• -Strong hospital collections experience with an understanding of commercial/PPO and other payer requirements.
• -Ability to investigate denials, identify their root causes, and determine whether they require correction, appeal, payer follow-up, or clinical escalation.
• -Advanced Excel skills, including sorting and filtering large datasets, pivot tables, VLOOKUP/XLOOKUP, reporting, and trend analysis.
• -Previous senior or lead experience overseeing collectors or healthcare revenue cycle staff.
• -Ability to develop reporting for leadership and translate data into actionable denial-prevention recommendations.
• -Working knowledge of UB-04 facility claims and general ICD-10-CM, CPT, and HCPCS coding principles.
• -Associate degree in Healthcare Administration, Business Administration, Finance, or a related discipline preferred, or equivalent relevant experience.
• -Cerner experience or Epic experience.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day.

We are an equal employment opportunity/affirmative action employer that believes everyone matters.

Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.

If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to [e-mail].