Kennedy Krieger Institute

  • DENIALS ANALYST

    Job Locations US-MD-Baltimore
    Department
    Patient Accounting
    ID
    3887
    Job Location : Street
    2931 E. Biddle St.
    # of Hours
    40
  • Overview

    JOB ID  3887

     

    The Denials Analyst is responsible for conducting a financial analysis of payer contracts in order to determine overall financial responsibility by payers  versus payer denials and reimbursements. This staff member will also work with management and staff to identify trends and process improvement opportunities in the billing function to reduce denials and write-offs.

    Responsibilities

    1. Timely identify denials by payer using the Rycan Software and Patient Accounting to determine the appropriate follow up and resolution required ensuring maximum reimbursement for services provided.
    2. Identify emerging denial/payer issues that require further action and communicate that to management and involved departments.
    3. Utilize problem solving abilities in order to assess and resolve complex billing problems and prevent recurring denials.
    4. Obtain reimbursement policies from the payer by accessing the appropriate payer resources (customer service, website, facsimile, etc.) in order to assess and respond accordingly to denials.
    5. Submit appeals, reconsiderations or re-determinations according to payer requirements, based upon denial.
    6. Monitor, document and track the status of all targeted accounts under specified denial codes and take appropriate action such as resubmitting the claim or contracting insurance company.
    7. Timely resubmission/retransmission of claims and verification of claim acceptance where appropriate for assigned account balances.
    8. Interact effectively with management/peers/internal parties/and external parties to resolve a diverse range of problems encountered in the life cycle of a claim.
    9. Perform general accounting transactions via completion of adjustment forms, charge correction forms, and payment transfer forms.
    10. Assist Administrator with account policy development and standard operating procedures to maximize reimbursements.

    Qualifications

    EDUCATION:

    • Associate’s degree (or equivalent credits) in Accounting, Finance, Business Administration or related discipline required.
    • Bachelor’s degree preferred.

    EXPERIENCE:

    • Minimum of three years’ experience in patient accounts, collections, healthcare billing or related setting required.

     

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