Remote Denial Recovery & Reimbursement Analyst

UF Health; Gainesville (FL); On-site; USD 70,000 - 110,000; Full time

Job summary

UF Health is seeking a full-time remote Denials Analyst to manage clinical denials, optimize reimbursement, and ensure high coding standards across the enterprise.

You will analyze denial trends, collaborate with Managed Care and Compliance, educate departments on charging and coding practices, and drive improvements in authorization and documentation to reduce denials.

Requirements include CPC/COC/RHIT/RHIA/CCS, 1–2 years of coding and denial management experience, and a HS diploma.

Qualifications

• High School Diploma or GED
• One of CPC, COC, RHIT, RHIA, or CCS
• 1–2 years of coding experience with denial management or insurance experience

Responsibilities

• Manage clinical denials from denial workqueues, including resubmission, authorization verification, payer reprocessing, reconsiderations and appeals.
• Collaborate with managed care teams and payers to reduce denials and increase reimbursement.
• Develop recommendations for coding and documentation improvements based on denial analysis and guidelines.
• Complete assigned work within established productivity and accuracy standards.
• Use coding guidelines (ICD-10, CPT/HCPCS) to review, code, and correct accounts.
• Report, track and resolve denials; assist with audits and investigations as needed.
• Manage payer workqueues (Medicare, Medicaid, government and commercial payers).
• Research payer denials related to authorization and medical necessity and initiate timely appeals.
• Prepare detailed reconsiderations and appeals based on records and policies.
• Identify denial trends and escalate root causes for process improvements.
• Review payer communications for reimbursement risks and policy changes.
• Educate departments to improve documentation, coding, charging and authorization processes.

Skills

Denial management

Medical coding

Revenue cycle optimization

Payer denial analysis

Regulatory compliance

Education

CPC/COC/RHIT/RHIA/CCS certification

Tools

Epic

Coding software

Job description

UF Health is seeking a full-time remote Denials Analyst to manage clinical denials, optimize reimbursement, and ensure high coding standards across the enterprise.

You will analyze denial trends, collaborate with Managed Care and Compliance, educate departments on charging and coding practices, and drive improvements in authorization and documentation to reduce denials.

Requirements include CPC/COC/RHIT/RHIA/CCS, 1–2 years of coding and denial management experience, and a HS diploma.