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The LaSalle Network
Denials Specialist
Career Insights for Contracts Analyst
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Scorecard
Based on Illinois data
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What they do
A Contracts Analyst reviews business contracts for a company or organization. Reviews proposed contract terms and conditions, communicates with management about contract obligations, and communicates and negotiates with clients. Prepares contract cost estimates and reviews proposals for contract changes. Confirms that contract terms have been met before a contract is closed out.
$69,912 / year median in Illinois
-5% projected decline
Job Description
LaSalle Network is partnering with our client to hire a Denials Specialist in Skokie, Ill., for a contract-to-hire opportunity. This Denials Specialist role is ideal for someone who enjoys blending denial and appeal work with data integrity, reporting and cross-functional collaboration. In this on-site environment, the Denials Specialist will support denial prevention and revenue protection across multiple payor types while staying current on evolving regulatory requirements. Responsibilities Oversee denial and appeal workflows using the denial management system, including documentation, deadline tracking and timely payment/adjustment processing Audit denial data to correct errors, maintain data integrity and develop standard and ad-hoc reports to identify trends and variances Perform root-cause analysis on denials and provide feedback and education to departments and physician offices to reduce denials and improve processes Maintain current knowledge of Medicare, Medicaid and managed care requirements, including monitoring CMS guidance and industry changes Serve as a liaison across hospital departments and off-site facilities to support denial prevention and optimal reimbursement Perform RAC account review and reconciliation, including appeals for medically unlikely edits (MUE) rejections and related adjustments/refunds as appropriate Complete adjudication-related work, including calculating allowances, identifying contract inconsistencies and correcting account/insurance errors Qualifications High school diploma or equivalent required; associate degree in business, accounting or health care, or bachelor's degree preferred Minimum three years of experience in adjudication, reimbursement, denial management, utilization review or equivalent experience in a health care environment Epic experience required Knowledge of reimbursement models and related federal, state and regulatory rules and regulations (including Medicare, Medicaid and managed care) Proficiency with Microsoft Office products Familiarity with claims processing and coding concepts (CPT, HCPCS, DRGs and