Denial Analyst

Denial Analyst Location: 39000 Bob Hope Dr, Rancho Mirage, CA 92270 Duration: 03+ months with possible extension Facility: Eisenhower Medical Center Job type: Onsite Shift timing: 8:30 AM - 5:00 PM | Monday Friday Position Summary: Responsible for researching and resolving claim denials, ADR requests, and certs, submitting and tracking appeals, noting trends and providing monthly reports. Respond to audit requests (including RAC) from payors. Maintains a Library of Payer reference material regarding requirements for pre-authorization, medical necessity and documentation requirements. Works with the Revenue Cycle stakeholders (e.g. Admitting, Coding, Provider Liaisons, etc.) to provide information related to denials and opportunities for future denials

Specific Skills, Knowledge, Abilities Required: Strong Analytical skills, Proficient in Microsoft Windows with emphasis on Excel. Ability to prioritize and coordinate workflow and attention to detail. Knowledge of CPT, HCPC and ICD 10 coding requirements with emphasis on modifiers and diagnosis association. Working knowledge of LCD's, NCCI and MUE edits as well as a general knowledge of Commercial, HMO, and Medicare Advantage claims, authorization and documentation requirements.