Denial Prevention Analyst

* ** Focus on Patient Care.
** A selfless drive to serve and heal connects all MFB employees.
* ** Clinical Variety and Challenge.
** An inter-disciplinary approach and a top team of professionals create ever-changing opportunities and activities.
* ** Family Culture.
** We offer the stability of a large organization while nurturing the family/team atmosphere of a small organization.
* ** Trust in Each Other.
** Each employee knows that co-workers can be trusted to make the right decision for our family, patients, staff, and community.
* ** A Proud Tradition**. Years of dedicated, quality service to our patients and community have yielded a reputation that fills our employees with pride.
** Essential

Job Responsibilities *
* * Reviews explanation of benefits and benefits coverage to determine the best course of action.  If needed for further clarification, contact insurance carrier
* Analyzes denial trends for staff/organizational education purposes
* Research online medical bulletins and policies, pricing and contractual issues
* Reviews clinical documentation, coding and claim to determine if the times and services provided to patients were applied correctly
* Prepares and mails written rationale of claim reconsideration request
* Tracks all denials within a database for reporting
* Maintains appropriate established timelines for follow up on outstanding appeal/reconsideration requests
* Collaborates with other Revenue Cycle Management and clinical departments to resolve claim issues as needed
* Any other duties as assigned
* Associates Degree and a minimum of 3 years’ experience in healthcare denial prevention. Knowledge of payer benefit policies and utilization review experience.
* Possesses a high level of initiative, self-directed, highly motivated and analytically minded
* Comprehension of healthcare terminology
* Time management skills to handle multiple, competing demands and priorities, and work effectively under pressure
* Strong, effective organization and interpersonal skills
* Superior written communication skills, including ability to write well organized, concise payer appeals
* Collaborative team style and open communication, including with other departments
* Excellent analysis and problem solving skills
* Demonstrated commitment to organizational mission with a “
* whatever it takes”
* attitude to get the job done
* Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint)
* Excellent computer knowledge and use of appropriate Electronic Medical Records, Admissions, and Utilization Management applications
* IRF medical billing experience
* Knowledge of ICD-9-CM and CPT coding classification systems

At Mary Free Bed, we work towards putting everybody in motion. Fueled by our passion for innovative, integrated rehabilitation care, our teams work together to elevate everyone’s potential. Whether you’re here to ensure a safe environment at our hospitals, provide clinical care or help our patients navigate their next appointment, we’re united by the same mission: to restore hope and freedom through rehabilitation.

Everyone plays an integral role in defining a better future for ourselves, our patients, and our communities. You included.
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