Insurance Denials Analyst

Job Summary

Monitoring payer denials and payment variances, the full-time Insurance Denials Analyst will identify, appeal, and track payer denials while ensuring compliance with reimbursement processes in a 100% remote environment.

Key responsibilities

• Analyze and interpret data related to third-party payer activity to identify root causes of denials and implement process improvements
• Prepare reports on payment discrepancies and communicate findings to relevant departments to optimize reimbursement
• Participate in appeals and audits, resolving incorrect payments and managing communication with payer representatives

Required qualifications

• High school diploma or equivalent required; minimum of one year of college coursework in accounting, coding, insurance, or related field preferred
• Minimum of three years of insurance billing experience in a hospital or professional environment preferred
• Knowledge of third-party payer guidelines, billing requirements, and reimbursement methodologies
• Familiarity with regulatory compliance requirements related to reimbursement
• Proficiency in computer software applications relevant to billing and accounts receivable management