Technical Denials Analyst

🔥 5 minutes ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 10%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Med-Metrix

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2010

🏥 Healthcare

☁️ SaaS

💰 Private equity on 2025-09

Healthcare • SaaS

Med-Metrix is a company for which only a minimal web presence was provided (the page only displayed "Loading application... Your web browser must have JavaScript enabled... "). No product, market, or mission details were included in the supplied text. Based on the company name alone, it plausibly focuses on medical or clinical metrics, analytics, or healthcare software, but that is speculative and not confirmed by the provided information. Further public details would be required to be more specific.

📋 Description

• Serve as the subject matter expert for technical denials across commercial, Medicare, Medicaid, and managed care payers • Identify recurring patterns by payer, department, facility, denial reason, and business function, including billing, credentialing, claim submission, registration, and eligibility issues • Lead cross-functional working sessions with billing, patient access, credentialing, EDI, and other revenue cycle teams • Validate findings, determine root causes, define operational remediation steps, and support implementation • Monitor denial, rejection, and processing trends across payers and departments • Prioritize categories and accounts with the greatest operational or financial impact • Escalate material changes and emerging risks • Maintain recurring reporting on technical denial rates, trends, resolution timeliness, and recovery outcomes • Assess whether operational improvements are reducing recurrence • Document findings, recommendations, and agreed-upon operational actions • Follow up with responsible teams when results do not improve or denials recur • Advise revenue cycle and client leadership on technical denial risks, payer changes, and recommended priorities • Use, protect, and disclose patients’ PHI in accordance with HIPAA standards • Comply with Information Security and HIPAA policies and procedures • Limit viewing of PHI to the minimum necessary • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree in healthcare administration, business, finance, or a related field; an equivalent combination of education and progressive revenue cycle experience will be considered • 4+ years of experience in healthcare billing, claims, provider credentialing, EDI, business office, or technical denials analysis, including leading denial prevention initiatives • Advanced knowledge of commercial, Medicare, Medicaid, and managed care payer requirements, including common claim submission, processing, and denial rules • Ability to analyze denial data and identify meaningful patterns by payer, department, facility, denial reason, or business office function • Demonstrated ability to identify root causes, lead cross-functional teams through operational remediation, and sustain results without day-to-day direction • Strong working knowledge of CARC/RARC denial and remark codes and the 837/835 claim lifecycle • Comfortable with large claims/remittance data sets • Experience working with multiple payer portals, clearinghouse platforms, or patient accounting systems preferred • Exposure to SQL or BI tools for claims analysis preferred • Experience supporting denial analysis across multiple facilities, departments, or payer types preferred • Proficiency in Microsoft Office Suite, with strong Excel skills • Strong interpersonal and influencing skills, with the ability to communicate and present findings at all levels of the organization, including executive leadership • Strong problem solving and creative skills and the ability to exercise independent judgment and make decisions based on accurate and timely analyses • High level of integrity and dependability with a strong sense of urgency and results oriented • Excellent written and verbal communication skills required • Must possess a smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes

🏖️ Benefits

• Occasional travel to client facility sites may be required • Ability to work outside of normal business hours to support special projects • Smartphone or electronic device capable of downloading applications provided/required for multifactor authentication and security purposes

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume