DENIALS ANALYST - Billing Department

UHS•Las Vegas, NV

13d

About The Position

Western Region CBO The Western Region Consolidated Business Office provides business office services including billing, collections, cash posting, pre-access management, variance and customer service to our affiliated UHS facilities. We are seeking dynamic and talented individuals to join our team. Job Description: Triage all denied claims to understand the reason for denial or dispute. Work closely with Nurse Auditors to ensure they have all the needed information to support their medical necessity appeals. Prepare appeal letters, PDR forms, or other documentation required for the appeals process, ensuring accuracy, completeness, and adherence to timelines and regulations. Conduct thorough research and investigation to gather relevant information, documentation, and evidence to support the appeal or dispute. Follow up and track the status of appeals and escalate as necessary to ensure timely resolution. ement compensation, and producing cost reports. Ability to think critically, attention to detail, interpersonal skills and experience with hospital acute care payer contracts is preferred.

Requirements

High school diploma or equivalent.
2 years healthcare/collection experience and or equivalent experience in a hospital setting.
Minimun of 2 years of previous Collections/Appeals experience
Strong analytical, organization, communication, and problem-solving skills, as well as a thorough understanding of the denial/appeals process.
Computer proficiency to include word processing, spreadsheet, database, and patient accounting system.
Demonstrated knowledge of insurance billing relating to patient reimbursement.
Must be able to identify trends or patterns in denial reasons and provide feedback to leadership to improve processes and reduce future denials.

Nice To Haves

Ability to think critically, attention to detail, interpersonal skills and experience with hospital acute care payer contracts is preferred.

Responsibilities

Triage all denied claims to understand the reason for denial or dispute.
Work closely with Nurse Auditors to ensure they have all the needed information to support their medical necessity appeals.
Prepare appeal letters, PDR forms, or other documentation required for the appeals process, ensuring accuracy, completeness, and adherence to timelines and regulations.
Conduct thorough research and investigation to gather relevant information, documentation, and evidence to support the appeal or dispute.
Follow up and track the status of appeals and escalate as necessary to ensure timely resolution.