Denials Analyst - FT/Day Shift (8:00am-4:30pm)

Employer
Anne Arundel Medical Center
Location
Annapolis, MD
Posted
Jun 20, 2017
Closes
Jun 21, 2017
Function
Analyst
Industry
Healthcare
Hours
Full Time
Refer Save Apply Job ID: JRK-33134 Description: The Denials Analyst position is responsible for AAMC denial management tracking and trending by denial reason and value, determination of root cause of denials, and translating root causes into timely and meaningful information to mitigate future denials.Clinical Denial review and actions include:Monitors, reviews and rectifies denial related pre-bill edits to ensure the generation of clean claims and to mediate any process related issues that result in pre-bill edits. Addresses root cause of denial related pre-bill edits.Monitors, reviews and maps payer remittance denial codes to internal denial codes.Tracks and trends self-denials, payer denials and denial write-offs (rolling 18 months).Maintains the denials initiatives matrix identifying denial activity, source of denials, remediation needed and provides consultative guidance for corrective action.Provides subject matter expertise in evaluating, implementing and utilizing Epic or other denial management software.Coordinates all denial related outsourcing to vendors/attorneys for denial appeals and follow-up. Maintains internal reporting to monitor vendor/attorney performance.Collaborates with Clinical Denial Specialist in developing internal educational sessions for various stakeholders (clinicians, physicians, care managers, etc.) to convey denial activity, specific reasons for denied claims and recommends process enhancements to mitigate denials.Possesses a high degree of knowledge of Epic EMR functionality and participates on Epic upgrade teams to ensure optimal denial management system functionality is in place.Effectively and efficiently data mines Epic claim information to identify denial trends, conveys root cause of denials to respective clinical teams and collaborates with clinical teams to rectify denials.Participates on the Revenue Cycle Solutions Group team to convey denial activity and mitigation plans. Recommends system related modifications, as needed, to mitigate denials.Develops and maintains positive payer relationships in dealing with denials, as needed.Interacts with Clinical Denials Specialist, care management, and physician advisors to evaluate policies and practices to mitigate denials.Identifies and escalates denial trends by payer, physician, denial reason, etc. to senior management. Required License/Certification: Outpatient coding certification preferredRequired Minimum Experience/Qualifications: Five years of relevant hospital patient financial services experience with focus on denials management. Hospital revenue cycle knowledge.Highly analytical with strong knowledge of computer software programs (Epic, Excel).Excellent verbal and written communication skills. Effective organizational skills and ability to function as a team player. Requirements: Expertise Finance Finance Schedule Regular Full Time Regular Full Time Location Annapolis Annapolis