Revenue Cycle - Denials Analyst

Winner Regional Healthcare Center • Winner, SD

2d • Hybrid

About The Position

The Denials Analyst position will work collaboratively with the Revenue Cycle teams to recover complex aged accounts and denials by doing account and denial follow-up. This position will also help identify and report any denial/non-payment trends or software issues to the Director of Revenue Cycle in an effort to correct issues that may be hindering clean claims going to payers or hindering prompt payment. This role is built for someone who is fast paced, loves digging in and untangling denials, thrives on collaboration and enjoys a good challenge. Remote possibility for the right driven, self-directed, trustworthy applicant.

Requirements

• Associates Degree or equivalent combination of education and experience in lieu of degree.
• 3+ years in hospital billing, denials, appeals, and collections.
• Ability to comprehend payer 835 and paper remits and knowledge of CARC/RARC codes/denial reasons.
• Understanding of CCI edits, CPT, HCPCS, ICD-10 and Revenue Codes.
• Strong PC skills (Windows/Microsoft products) and eagerness to adopt new revenue cycle platforms and analytics tools.
• Exceptional organization, deadline ownership, and a “no claim left behind” mentality.
• Ability to read, write, speak and understand the English language.
• Excellent oral and written communication skills.
• Ability to virtually attend meetings/discussions in a professional manner and display a professional image.
• Knowledge of computer and general office equipment.

Nice To Haves

• Experience with Epic EMR (HB) preferred.
• Knowledge of claims, codes, payer billing rules/regulations, and denial/follow-up processes in a healthcare facility preferred.
• Positive outlook and excitement to learn new things as healthcare is everchanging.

Responsibilities

• Working payer denials, documentation requests and appeals in a timely manner to secure payment for services.
• Working various follow up WQs (Work queues) and A/R agings in an effort to secure payment before account goes timely with payer.
• Status claims with payers that have had no activity and remain unpaid via payer portals, phone calls, emails and take appropriate action.
• Identify and report denial trends seen with specific services, end users and Providers so preventative fixes or education can be performed.
• Supporting the projects and initiatives of the Revenue Cycle team. This may include brainstorming meetings, conducting research for payer criteria and preparing documents/written processes.
• Will sign up for payer listservs, newsletters and webinars to stay on top of industry and payer changes.
• Misc related duties as assigned
• To collect on claims/accounts for prompt payment staying within payer timely filing limitations.
• Clean up unpaid arrears via research and troubleshooting of accounts in an effort to collect payment in a timely manner.
• Improve cash flow and days cash on hand.
• Decrease days in A/R.
• Software/Process/Staff training and improvements to insure clean claims, fewer denials and prompt payment/better cash flow for the organization.

Benefits

• Initial Tuberculosis (TB) test and drug screening is required by Winner Regional Health.
• Rubella titer will also be drawn upon hire and immunization is required if no past exposure or indication of immunization.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree