Denials Management Analyst

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November 14

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Shriners Children's

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Healthcare Insurance • Non-profit • Science

Shriners Children's is a non-profit organization that has been providing specialized pediatric care for over 100 years. With a commitment to excellence, their compassionate team of doctors and nurses focuses on delivering personalized care across various specialties, including burn care, orthopedics, and pediatric rehabilitation. They also engage in innovative research aimed at improving medical treatments and the overall quality of life for children.

10,000+ employees

Founded 1922

⚕️ Healthcare Insurance

🤝 Non-profit

🔬 Science

📋 Description

• 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

🎯 Requirements

• 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)

🏖️ Benefits

• 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