Denial Management Analyst

Nmble Medical is partnering with a leading Indianapolis healthcare organization to hire a detail-oriented and analytical Denial Management Analyst. This role is responsible for investigating, analyzing, and resolving denied insurance claims while collaborating with revenue cycle, billing, coding, and clinical teams to improve reimbursement outcomes and reduce future denials. The ideal candidate is passionate about revenue cycle performance, root cause analysis, process improvement, and maximizing reimbursement while ensuring compliance with payer guidelines and healthcare regulations. Key Responsibilities Analyze and resolve denied, underpaid, and rejected insurance claims across multiple payer types. Investigate denial trends and identify root causes impacting reimbursement and cash flow. Prepare and submit appeals with supporting documentation to secure appropriate reimbursement. Monitor denial work queues and ensure timely follow-up in accordance with organizational standards. Collaborate with billing, coding, registration, and clinical teams to address denial drivers and improve processes. Review payer policies, contracts, and reimbursement guidelines to ensure accurate claim resolution. Track and report denial metrics, trends, and key performance indicators (KPIs). Develop recommendations to reduce denials and improve first-pass claim acceptance rates. Maintain compliance with

HIPAA, CMS

regulations, payer requirements, and organizational policies. Support revenue cycle improvement initiatives and special projects as assigned. Required Qualifications High school diploma or equivalent required; Associate's or Bachelor's degree preferred. Minimum of 2 years of healthcare revenue cycle, denial management, medical billing, accounts receivable, or claims resolution experience. Strong understanding of insurance claim processing, payer guidelines, appeals, and reimbursement methodologies. Experience working with Medicare, Medicaid, and commercial insurance carriers. Knowledge of ICD-10, CPT, and HCPCS coding concepts. Experience utilizing electronic health records (EHR) and revenue cycle management systems. Advanced analytical, problem-solving, and organizational skills. Strong written and verbal communication skills. Proficiency with Microsoft Excel, Word, and reporting tools. Preferred Qualifications Certified Revenue Cycle Representative (CRCR) or similar certification preferred. Experience in physician practice, hospital, imaging, specialty practice, or healthcare revenue cycle environments. Familiarity with denial prevention strategies and revenue cycle optimization initiatives. What Success Looks Like Reduced denial volume and aging accounts receivable. Improved appeal success rates and reimbursement recovery. Identification and correction of recurring denial trends. Strong collaboration across operational, billing, coding, and clinical teams. Accurate reporting and data-driven recommendations that improve revenue cycle performance.