Healthcare Denials Analytics Lead

Med-Metrix; Parsippany-Troy Hills (NJ); Presencial; USD 105 000 - 135 000; Tempo integral

Resumo da oferta

Med-Metrix in Parsippany, NJ, seeks a Technical Denials Analyst to lead identification and mitigation of non-clinical denials across payers. You will analyze denial patterns, partner with revenue cycle teams, and drive remediation initiatives to reduce recurrence.

You will maintain recurring denial rate reports, present findings to leadership, and advise on payer changes and priority actions while safeguarding PHI and complying with HIPAA.

Qualificações

• Bachelor's degree or equivalent in a related field.
• 4+ years in healthcare billing, claims, credentialing, EDI, or denials analysis including leading denial prevention initiatives.
• Advanced knowledge of commercial, Medicare, Medicaid, and managed care payer requirements and denial rules.
• Ability to analyze denial data and identify meaningful patterns by payer, department, or function.
• Experience leading cross-functional remediation initiatives and sustaining results.

Responsabilidades

• Serve as SME for technical denials across commercial, Medicare, Medicaid, and managed care payers; identify recurring patterns and issues.
• Lead cross-functional sessions to validate findings, define remediation steps, and support implementation.
• Monitor denial trends across payers; prioritize categories with greatest impact and communicate risks.
• Maintain recurring reports on denial rates and recovery outcomes; guide actions to reduce recurrence.

Conhecimentos

Interpersonal skills

Communication skills

Problem solving

Analytical thinking

Project coordination

Formação académica

Bachelor's degree in healthcare administration, business, finance, or related field

Ferramentas

Excel

SQL

BI tools

Microsoft Office Suite

Descrição da oferta de emprego

Med-Metrix in Parsippany, NJ, seeks a Technical Denials Analyst to lead identification and mitigation of non-clinical denials across payers. You will analyze denial patterns, partner with revenue cycle teams, and drive remediation initiatives to reduce recurrence.

You will maintain recurring denial rate reports, present findings to leadership, and advise on payer changes and priority actions while safeguarding PHI and complying with HIPAA.