Denials & Appeals Analytics Specialist

Eisenhower Medical Center; United States; On-site; USD 30,000 - 46,000; Full time

Job summary

Eisenhower Health seeks a Denials Analytics Specialist to research and resolve claim denials, process ADRs, and track appeals. You will work with revenue cycle teams to improve workflows, respond to audits, and maintain payer reference materials for pre-authorization and medical necessity requirements.

Required: high school diploma or GED, 3 years of hospital billing experience focused on denials and appeals; preferred: associate degree and coding program enrollment.

Qualifications

• High school diploma required; preferred associate degree.
• Three years hospital or professional billing experience in denials follow-up.
• Strong knowledge of CMS rules, CPT/HCPCS/ICD-10 coding.

Responsibilities

• Research and resolve claim denials and ADR requests.
• Submit and track appeals; monitor payer requirements.
• Identify denials trends and produce monthly reports.
• Respond to audit requests and maintain payer reference materials.
• Maintain HIPAA compliance and protect patient information.
• Collaborate with Revenue Cycle stakeholders to improve processes.
• Create and submit strong concise payer appeals for revenue recovery.

Skills

Denials analytics

Analytical skills

Attention to detail

MS Office Suite

HIPAA knowledge

Education

High school diploma or GED

Associate's degree (preferred)

Tools

Epic EHR

Microsoft Office Suite

Job description

Eisenhower Health seeks a Denials Analytics Specialist to research and resolve claim denials, process ADRs, and track appeals. You will work with revenue cycle teams to improve workflows, respond to audits, and maintain payer reference materials for pre-authorization and medical necessity requirements.

Required: high school diploma or GED, 3 years of hospital billing experience focused on denials and appeals; preferred: associate degree and coding program enrollment.