Denials Management Analyst – Anesthesia

🕒 5 days ago

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Shriners Children's

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1922

⚕️ Healthcare Insurance

🤝 Non-profit

🔬 Science

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.

📋 Description

• Analyzing denials data and creating payor metrics • Tracking and trending denials and results from multiple systems • Identifying and trending root causes and reporting out findings • Assisting in mapping out process improvement opportunities • Coordinating payor denials and audit activities for timely processing • Communicating and coordinating with various individuals/distributions • Monitoring day-to-day activities related to claims denials and audit reviews • Maintaining healthcare tracking tool/application • Supporting projects and initiatives of the Denials Management Team

🎯 Requirements

• Bachelor's degree, or equivalent combination of education and experience • 3 years of related Anesthesia 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 • Healthcare Revenue Cycle management including: • Therapy (Physical/Occupational/Speech) • Radiology • Pediatrics/Pediatric Orthopedics • Anesthesia • EDI Transaction sets including 837I, 837P • 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 insurance • Critical illness insurance • Pet insurance