Denials Management Analyst

Job Summary

A company is looking for an Analyst, Denials Management to support Denials Management and revenue integrity functions.

Key Responsibilities:

• Review and analyze daily client transaction files to estimate expected reimbursements and invoiceable amounts
• Manage clinical and technical denials, including DRG downgrades, and coordinate with appeals or clinical review teams
• Develop monthly and quarterly cash/reimbursement forecasts and track variance to forecast using observed trends

Required Qualifications:

• 2-5 years of experience in revenue cycle, denials management, or related healthcare finance role
• Direct experience with DRG downgrades and denial categories impacting reimbursement
• Proficiency in Microsoft Excel, including vlookups, pivot tables, and basic formulas
• Experience with reconciling daily transaction files and familiarity with invoicing/billing concepts
• Ability to build monthly/quarterly forecasts and explain assumptions and variance drivers