Hospital - Denial Management Analyst
About The Position
The Denial Management Analyst manages disputed or denied claims by analyzing medical records and payer policies to recover reimbursements in a hospital setting. Reviews and responds to payer audits. Ensures accurate ICD-10 coding, analyzes denial and audit trends to identify root causes, and coordinates appeals through documentation, contract reviews, and payer negotiations. The analyst supports process improvements, tracks appeals, and collaborates with clinical and revenue teams to efficiently review and resolve claim denials. Follows payer-specific rules, federal and state regulations, and industry trends under limited supervision.
Responsibilities
- Manages disputed or denied claims by analyzing medical records and payer policies to recover reimbursements
- Reviews and responds to payer audits
- Ensures accurate ICD-10 coding
- Analyzes denial and audit trends to identify root causes
- Coordinates appeals through documentation, contract reviews, and payer negotiations
- Supports process improvements
- Tracks appeals
- Collaborates with clinical and revenue teams to efficiently review and resolve claim denials
- Follows payer-specific rules, federal and state regulations, and industry trends
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
Number of Employees
1-10 employees
