Revenue Integrity & Denials Analyst

Westchester Medical Center; Town of Mount Pleasant (NY); On-site; USD 60,000 - 90,000; Full time

Job summary

Westchester Medical Center is seeking a Denials Specialist to analyze denial data, monitor write-offs, and drive recovery across its Denials Management functions. The role collaborates with clinical and patient access teams to reduce recurring denials and improve preventive measures.

The ideal candidate has 2–3 years in revenue cycle or denials management, a bachelor’s degree in business/finance/healthcare administration preferred, and strong communication and organizational skills.

Qualifications

• Minimum of two to three years of experience in revenue cycle, denials management or related patient financial services.
• Bachelor’s degree in business, finance, or healthcare administration preferred; equivalent work experience may substitute degree.
• Demonstrated knowledge of healthcare management, collections management, Medicaid and Medicare.
• Experience in establishing and managing claim denial activities, collection processes and methodology.
• Strong organizational skills and ability to multi-task.

Responsibilities

• Coordinates all data collection, analysis, appeal, write-off and reporting activities affecting the denial process.
• Communicates with clinical departments, on-site staff, and Patient Access and Mid-Cycle coordinators to reduce or eliminate unnecessary recurring denials and establishes appropriate prevention measures.
• Ensures that all activities related to Denials Management functions meet department requirements, maximizes revenue collection, and achieves leading practice levels of performance.
• Works with Revenue Integrity Leaders for charge related denials.
• Monitors denial write-offs to ensure staff is using the appropriate write-off codes.
• Monitors any denial vendor relationships for compliance and performance, and suggests modifications to Revenue Cycle leadership as necessary.
• Monitors contract compliance and escalates to Managed Care staff as needed.
• Provides denial trends to Billing Functional Leader for operational improvement.
• Works with Local System Coding leaders to determine appropriate changes for DRGs, CPT, and ICD PX related denials.
• Displays commitment to treating both internal and external constituents as clients and customers, maintaining a flexible customer service approach and orientation that emphasizes service satisfaction and quality.
• Works under the direction of the Denial Manager to analyze denial and underpayment reports, provide feedback on root causes of denials, and formulate denials resolution strategies.
• Works with the Follow-up Manager to establish and monitor accounts receivable management and cash collection goals and targets.
• Creates a department dashboard.
• Works under the direction of the Denial Manager to ensure that key performance metrics are met on a daily, weekly and monthly basis.
• Effectively uses automated systems to perform work assignments.
• Performs related duties as assigned.

Skills

Strong organizational skills

Written communication

Verbal communication

Customer service orientation

analytical thinking

Education

Bachelor’s degree in business, finance, or healthcare administration preferred

Tools

Patient accounting systems

Job description

Westchester Medical Center is seeking a Denials Specialist to analyze denial data, monitor write-offs, and drive recovery across its Denials Management functions. The role collaborates with clinical and patient access teams to reduce recurring denials and improve preventive measures.

The ideal candidate has 2–3 years in revenue cycle or denials management, a bachelor’s degree in business/finance/healthcare administration preferred, and strong communication and organizational skills.