Denials Management Specialist (Remote After Training)

Bestcare; Omaha, Northern (NE, KY); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Nebraska Methodist Health System is seeking a Denials Management Analyst at the Methodist Corporate Office in Omaha, NE. The role focuses on reviewing denials, researching payer contracts, and escalating appeals to maximize reimbursement in line with CMS regulations.

You will support staff, participate in payer meetings, and may train others on contracts and reimbursement processes. The position is hybrid with potential work-from-home after training.

Qualifications

• High School Diploma or GED required.
• College coursework in accounting and/ or health care preferred.

Responsibilities

• Review denials for commercial/government, physician/facility, and escalate appeals to payers to maximize reimbursement.
• Analyze denials against contract language, payer medical policy, NMHS coding and authorization processes; ensure timely follow-up.
• Research contractual and reimbursement issues; respond to inquiries from internal and external sources; correct denials and finalize RCA per policy.
• Assist staff with workload and respond to special requests with accurate information; provide contract/payor recommendations.
• Participate in payer meetings; track payer agenda issues; provide training on contracts and reimbursement as needed.

Skills

10-key data entry

Verbal & written communication

Medical terminology

Payer websites

UB/HCFA billing formats

ICD/CPT familiarity

Data analysis

Confidentiality

Education

High School Diploma or GED

College coursework in accounting and/ or health care

Tools

Microsoft Office

Job description

Nebraska Methodist Health System is seeking a Denials Management Analyst at the Methodist Corporate Office in Omaha, NE. The role focuses on reviewing denials, researching payer contracts, and escalating appeals to maximize reimbursement in line with CMS regulations.

You will support staff, participate in payer meetings, and may train others on contracts and reimbursement processes. The position is hybrid with potential work-from-home after training.