Hospital - Denial Management Analyst

UT Health San Antonio • San Antonio, TX

1d • Onsite

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.

Requirements

• Analysis of medical records and payer policies.
• Experience with ICD-10 coding.
• Understanding of denial and audit trends.
• Skills in documentation, contract reviews, and payer negotiations.
• Familiarity with payer-specific rules, federal and state regulations, and industry trends.
• Ability to work 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 1-10 employees