Denial Management Analyst

Job Details

• City/State: Bronx, New York
• Grant Funded: No
• Department: No Mgr
• Work Shift: Day
• Work Days: MON-FRI
• Scheduled
  
  Hours:
  
  8:30 AM-5 PM
• Scheduled Daily
  
  Hours:
  
  7.5 HOURS
• Pay Range: $49,920.00-$62,400.00

Researches and analyzes denials on a daily basis, identifies root causes, and processes resubmissions/appeals with the goal of overturning the denial and getting paid by the insurance carrier, maximizing revenue for the division.

• Three to five years of progressive experience in appeal/denial management - Preferred
• Strong knowledge of health plan requirements
• Strong analytical, statistical analysis skills required. Strong knowledge of EPIC, Microsoft Excel, Word and Power Point skills required
• Knowledge of federal, regional and state payer coverage patterns (CMS, fiscal intermediary, and Administrative)
• Strong organizational and communication skills; professionalism, able to work with all levels of staff.
• Bachelor's Degree preferred (Certified Professional Coder (CPC))
• Associate's Degree required (Medical Billing experience)
• Certified Professional Coder (CPC) required
• EPIC Cadence, HB, PB certifications preferred
• Knowledge of CPT coding and ICD
  10 diagnosis required
• Ability to work and effectively multi-task in a fast-paced clinic environment with patients with developmental disabilities.

Montefiore Medical Center is an equal employment opportunity employer. Montefiore Medical Center will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.