Denial Prevention Analyst

3 days ago

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Savista

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Revenue Cycle Management • HIM • Patient Engagement • Revenue Integrity • Accounts Receivable Management

1001 - 5000

Description

• Analyze denial trends and patterns to identify root causes and implement proactive measures to prevent future denials. • Collect, compile, and analyze data from various sources to generate comprehensive reports on denial rates, reasons, and impacts. • Present detailed monthly reports and insights to hospital and physician stakeholders, highlighting key findings and recommendations for improvement. • Work closely with hospital and physician staff to understand their needs, address concerns, and provide targeted solutions to minimize denials. • Develop and implement process improvements to enhance efficiency and reduce the likelihood of denials. • Provide training and education to staff on best practices for denial prevention and management. • Ensure compliance with all relevant regulations, guidelines, and standards related to claims and denials. • Maintain accurate and up-to-date documentation of denial cases, interventions, and outcomes. • Monitor and report on key performance indicators (KPIs) related to denial prevention efforts.

Requirements

• Bachelor’s degree in healthcare administration, business administration, finance, or a related field. • Minimum of 3 years of experience in denial management, revenue cycle analysis, or a related field within a healthcare setting. • Strong analytical and problem-solving skills • Excellent communication and presentation abilities • Proficiency in data analysis tools and software • Knowledge of healthcare billing, coding, and reimbursement processes • Attention to detail and accuracy • Ability to work independently and collaboratively within a team • Certification in healthcare compliance, coding, or revenue cycle management is a plus.