Denials Management Analyst

Central Maine Healthcare Corporation•Lewiston, ME

2d•$25 - $31•Onsite

About The Position

The Denials Management Analyst identifies, analyzes, and resolves technical-based denials from insurance payers. The analyst works with revenue cycle staff and governmental and non-governmental insurance payers to identify denial sources and develop processes to eliminate or minimize denials and rejections, improving cash flow. The role works denied and underpaid accounts to obtain full reimbursement for services through effective appeal writing and identifies root causes of denials and underpayments. This is a full-time, onsite position in Lewiston, Maine, with a day shift. The stated pay range is $25.00 to $30.79. Central Maine Healthcare is an integrated healthcare delivery system serving approximately 400,000 residents across central, western, and midcoast Maine, with more than 40 primary and specialty care locations.

Requirements

One year of experience billing or collecting for commercial insurance.
Two years of experience billing or collecting for Medicare or Medicaid.
One year of experience within the denials management process.
Insurance knowledge, including basic coding, claims submission, collections, and prior authorization processes.
Familiarity with multiple insurances and their medical policies, professional and facility billing requirements.
Experience and understanding of billing reports and aged accounts.
Basic understanding of provider credentialing and third-party payer contracts.
Familiarity with CPT and ICD-9 manuals.
Familiarity with UB and HCFA 1500.
Ability to request and research billing procedure information from Medicaid, commercial, and other third-party payers.

Responsibilities

Identify, analyze, and resolve technical-based denials from insurance payers.
Work with revenue cycle staff and governmental and non-governmental insurance payers to identify denial sources.
Develop processes to eliminate or minimize denials and rejections and improve cash flow.
Work denied and underpaid accounts to obtain full reimbursement for services through effective appeal writing.
Identify root causes of denials and underpayments.