Denials Resolution Analyst

Job Summary

Facilitating payment recovery efforts, the full-time Denials Resolution Analyst will manage denied and underpaid accounts for assigned clients while working remotely to enhance revenue through effective claims review and appeal processes.

Key Responsibilities

• Review, evaluate, and appeal outstanding claims using proprietary software and tools
• Determine correct reimbursements by analyzing payment documentation and hospital contracts
• Research and submit complex underpayment appeals, ensuring timely reimbursement and follow-up with payers

Required Qualifications

• High School Diploma or GED required; Associate's or Bachelor's Degree preferred
• 5+ years of experience in healthcare billing or collections
• 1+ years of client-facing or customer service experience
• Intermediate understanding of insurance claims processing and medical terminology
• Strong computer proficiency, including MS Office applications