Billing and Denials Analyst @ Sarahbush

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Billing and Denials Analyst

Job Description

• Monitor and analyze billing trends, claim denials, rejection rates, and reimbursement performance.
• Identify patterns and root causes of denials.
• Identify high-dollar denials, recurring denial trends, and claims at risk for timely filing.
• Evaluate denial trends to determine opportunities for prevention, correction, and recovery of revenue.
• Review denied claims, determine appropriate next steps, and identify opportunities for rebilling, appeals, or other resolution.
• Monitor denial-related financial performance and report findings to leadership.
• Develop and maintain dashboards, reports, and tracking tools to monitor billing and denial performance.
• Prepare summaries and recommendations for leadership, revenue cycle committees, and clinic management.
• Compare performance across reporting periods and clinic locations to identify improvement opportunities.
• Develop recommendations for standardized workflows and best practices to prevent avoidable denials.
• Assist with the development of corrective action plans for clinics with elevated denial rates
• Collaborate with providers, clinic leaders, registration staff, prior authorization teams, educators and address denial trends.

Department: Practice Management

Hours: Full time, 40 hours/week

Required: High School Diploma

Pay: Based on experience, starting at $21.62

Responsibilities

Assists with all special projects and other duties as assigned., Communicate denial trends and process opportunities to the Revenue Cycle

Denials/Billing Team., Develops reporting tools that effectively measure and monitor processes throughout the denials management process in order to support process improvement., Identifies, analyzes and researches frequent root causes of denials and assists in the development of corrective action plans for resolution of denials., Identifies and pursues opportunities for improvement in denial performance to prevent future avoidable denials., Identifies and pursues opportunities for improvement in denial performance to prevent future avoidable denials., Researches and analyzes denial data and coordinates denial recovery responsibilities., Runs and disseminates monthly denial reports to appropriate areas., Serves as backup for

Credentialing Specialist and assists with credentialing projects as needed., Understands and applies payer coverage, reimbursement and medical policies.

Requirements

High School (Required)

Compensation

Estimated Compensation Range

$21.62 - $33.51Pay based on experience