Denials & Appeals Analyst — Revenue Recovery

Montefiore Health System; New York (NY); Sur place; USD 50 000 - 62 000; Plein temps

Résumé du poste

Montefiore Medical Center in Bronx, NY is seeking a denial management specialist to research and analyze denials daily, identify root causes, and submit resubmissions and appeals to overturn denials. The role focuses on maximizing revenue by securing insurer payments and ensuring accurate coding and documentation.

The ideal candidate will have 3–5 years in denial management, CPT/ICD10 knowledge, and certifications such as CPC; EPIC experience preferred.

Qualifications

• Three to five years of progressive experience in appeal/denial management.
• Strong knowledge of CPT coding and ICD10 diagnosis.
• Knowledge of federal, regional and state payer coverage patterns (CMS, etc.).
• Certifications such as CPC preferred; EPIC, HB, PB certifications preferred.

Responsabilités

• Researches and analyzes denials on a daily basis, identifies root causes, and processes resubmissions/appeals to overturn denials.
• Work to maximize revenue for the division by obtaining payments from the insurance carrier.
• Collaborate with staff at all levels to ensure accurate coding and documentation.

Description du poste

Montefiore Medical Center in Bronx, NY is seeking a denial management specialist to research and analyze denials daily, identify root causes, and submit resubmissions and appeals to overturn denials. The role focuses on maximizing revenue by securing insurer payments and ensuring accurate coding and documentation.

The ideal candidate will have 3–5 years in denial management, CPT/ICD10 knowledge, and certifications such as CPC; EPIC experience preferred.