Revenue Cycle Denial And Underpayment Analyst Senior

Senior Revenue Cycle Denial and Underpayment Analyst

The Senior Revenue Cycle Denial and Underpayment Analyst presents, analyzes, and trends denial and underpayment data to recover revenue for Centra. The analyst is responsible for accumulative analysis of revenue data across multiple areas and service lines in Centra for the purpose of recovering revenue and appealing denials. The analyst also identifies trends in denials and underpayments and works with managed care to present the data to payers for correction and investigation for payer contract violations.

Responsibilities

Essential Duties and Responsibilities:

• Compiles and communicates trends and areas of opportunity related to claim edits, rejections, and denials.
• Analyze and prepare metrics for presentation and investigation of trends.
• Collaborates with vendors and IT for system optimization and resolution of identified issues and trends.
• Presents and conducts work groups for trend resolutions and process improvements.
• Identify and resolve denials and underpayments.
• Serves as a resource for staff and payers seeking to resolve questions and/or concerns related to underpayments and denials.

Other Functions:

• Performs special projects as needed and assigned.
• Performs other duties as assigned.

Qualifications

Required Qualifications:

• High School Diploma
• Minimum five (5) years' experience in data analysis, denials, and/or healthcare accounts receivable.
• Previous experience leading, conducting, and interacting with all levels of staff.
• Fundamental understanding and comprehension of denial and underpayment processes.

Preferred Qualifications:

• Certified Coder
• Associate Degree