There are currently 3 open, full time Enterprise Denial Analyst Opportunities
The Enterprise Denial Analyst is responsible for reviewing technical denial claims, submitting reconsiderations or appeals. Reporting to the Enterprise Technical Denial Assistant Manager, this role is responsible to optimize the financial outcomes of the hospital-based revenue cycle through maintaining a low denial rate and high reimbursement rate at an enterprise level for UF Health. The enterprise denial analyst is considered a technical denial expert in denial management and ensures all denied claims are accurately worked from a technical/ billing perspective.
Initiates a root cause analysis of denied payment through comprehensive means including but not limited to: research of patient stays and treatment, review of payer contracts, analysis of historical denials, appeals and their outcomes, emerging trends in payer practices and requirements.
Works to maintain third-party payer relationships, including responding to inquiries, complaints and other correspondence.
Working in conjunction with the Enterprise Technical Denial Assistance Manager and Enterprise Sr Denial Manager,
maintains a strong working relationship with the Enterprise Managed Care Department to escalate and resolve atypical denial issues.
Knowledgeable of state/federal laws that relate to contracts and to the appeals process.
Working in collaboration with the different revenue cycle departments through the enterprise to establish best practice solutions to maximize reimbursement and minimize organizational write-offs.
Sorting and working multiple assigned payer work queues including Medicare, Medicaid, government payers, commercial payers, Medicare advantage plans, and others as assigned.
HS diploma required; Associates Degree or higher preferred.
If no degree, four years of experience required.
If degreed, 3 years of experience required.
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