Remote Denials Management Analyst

Best Care; United States; Hybrid; USD 42,000 - 62,000; Full time

Job summary

Nebraska Methodist Health System is seeking a Billing Specialist to review denials, analyze payments, and ensure maximum reimbursement under payer contracts and CMS regulations. The role includes collaborating with internal teams, supporting staff, and training on contract reimbursement processes.

Location: Omaha, NE; Schedule: Mon–Fri; potential for remote work after training. Strong knowledge of ICD/CPT, DRG, UB/HCFA formats, and payer websites is preferred.

Qualifications

• High School Diploma or GED is required.
• College coursework in accounting or health care is preferred.
• 1–2 years of experience with a 3rd party payer or health care provider.
• At least 1 year of insurance billing experience is preferred.
• Six months DRG reimbursement experience preferred.
• Experience researching institutional and professional claims for contract reimbursement.

Responsibilities

• Analyze denials against contracts, payer policies, NMHS coding, and authorization processes.
• Analyze payments to ensure accuracy and initiate corrective action with payers.
• Maintain follow-up and reporting to ensure reimbursement.
• Research contractual and reimbursement issues and respond to inquiries.
• Assist staff with workload and respond to special requests.
• Participate in payer meetings and escalate payer issues.
• Provide training on contracts and reimbursement to other areas as needed.

Skills

Microsoft Office

Data entry

Verbal communication

Written communication

Medical terminology

Payer websites

UB/HCFA billing formats

ICD knowledge

CPT knowledge

DRG knowledge

Confidentiality

Data analysis

Education

High School Diploma or GED

College coursework in accounting

College coursework in health care

Tools

None

Job description

Nebraska Methodist Health System is seeking a Billing Specialist to review denials, analyze payments, and ensure maximum reimbursement under payer contracts and CMS regulations. The role includes collaborating with internal teams, supporting staff, and training on contract reimbursement processes.

Location: Omaha, NE; Schedule: Mon–Fri; potential for remote work after training. Strong knowledge of ICD/CPT, DRG, UB/HCFA formats, and payer websites is preferred.