Denials and Resolution Analyst - CCSO - Business Services

DEFINITION

Denials and Resolution Analyst is under the supervision of one of the Business Service Supervisors. The Denials and Resolution Analyst is responsible for follow-up and monitoring under-payments from Third party payers. Responsible for data collection and analysis regarding specific Provider and/Facility Inquiries, Disputes and/or Appeals. Develops necessary policies and procedures and oversees quality assurance measures related to Provider and Hospital Disputes.

PREFERRED QUALIFICATIONS

: Must have good organizational skills, reading, writing and proven communication skills. Proficient in Excel. Must have 2 years of general medical office experience. Prefer 2 year of hospital/medical office billing and collections or can demonstrate an understanding of hospital/physician billing and collections. College degree preferred. High School Graduate with excellent organizational skills, ability to work independently and stay on task, Ability to learn and understand billing protocol and reimbursement issues, ability to maintain accurate and detailed charts/notes in the company system. 2 years formal education in business or equivalent experience. Must have at least 2 years of a Medical Office/Hospital billing setting.