Denials Management Analyst

🕒 Novembro 14, 2025

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Shriners Children's

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1922

⚕️ Seguro de Saúde

🤝 Sem Fins Lucrativos

🔬 Ciência

Healthcare Insurance • Non-profit • Science

A Shriners Children's é uma organização sem fins lucrativos que oferece cuidados pediátricos especializados há mais de 100 anos. Com um compromisso com a excelência, sua equipe compassiva de médicos e enfermeiros foca em fornecer atendimento personalizado em várias especialidades, incluindo cuidados para queimaduras, ortopedia e reabilitação pediátrica. Eles também se envolvem em pesquisas inovadoras destinadas a melhorar os tratamentos médicos e a qualidade de vida das crianças.

Descrição

• Analyzing denials data • Creating payor metrics • Tracking and trending denials • Reporting findings and mapping out process improvement opportunities • Coordinating payor denials and audit activities • Communicating and coordinating with various individuals/distributions • Assisting with monitoring of day-to-day activities related to claims denials • Maintaining the healthcare tracking tool/application • Supporting projects and initiatives of the Denials Management Team

🎯 Requisitos

• Bachelor's degree, or equivalent combination of education and experience • 5-7 Years in a Healthcare Revenue Cycle Environment including 3 years in Third Party Collection/AR Receivables and Denials Management • Epic PB Resolute experience • Knowledge of insurance contract rates and terms • Knowledge and understanding of Registration and Collections • Knowledge and understanding of Government and Managed Care billing, coverage and payment rules • Ability to comprehend payor 835 and paper EOB responses • Knowledge and understanding of NCCI edits, CPT-4, HCPCS, ICD-10 and Revenue Codes standards • Intermediate Excel skills • CRCR Certification (Preferred) • Epic Certification (Preferred)

🏖️ Benefícios

• All employees are eligible for medical coverage on their first day! • 403(b) and Roth 403 (b) Retirement Saving Plan with matching contributions of up to 6% after one year of service • Paid time off • Life insurance • Short-term and long-term disability • Flexible Spending Account (FSA) plans • Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is elected • Tuition reimbursement • Home & auto insurance • Hospitalization • Critical illness insurance • Pet insurance