USA Health · 1 month ago
Revenue Integrity Denial Analyst- USA Health
United States
Full-time
Remote
Mid Level
4+ years expUSA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. The Revenue Integrity Denial Analyst is responsible for reviewing technical denial claims, optimizing financial outcomes of the hospital-based revenue cycle, and maintaining relationships with third-party payers to mitigate denials.
EducationHealth CareMarket Research
Responsibilities
Reviewing technical denial claims
Finding denial root cause
Helping to create action plans for overall system denial prevention
Optimizing the financial outcomes of the hospital-based revenue cycle
Maintaining a low denial rate and high reimbursement rate at an enterprise level
Initiates a root cause analysis of denied payment
Research of patient stays and treatments
Review of payer contracts
Analysis of historical denials, appeals and their outcomes
Emerging trends in payer practices and requirements
Works closely with the managed care department
Responding to inquiries, complaints and other correspondence
Working with the clinical nurse reviewers, charge analysts and revenue integrity analysts
Identify gaps in the clinical and financial workflows
Coordinates work efforts to fill and correct gaps for denial mitigation
Maintains a strong working relationship with the enterprise managed care department
Escalate and resolve atypical denial issues
Maintains a strong working relationship with clinical and financial leaders throughout the organization
Demonstrated knowledge of hospital billing and reimbursement, denials and appeals, and federal and state regulations governing the health care industry
Excellent critical thinking and analytical skills
Attention to detail and ability to complete the job with minimal errors and to work independently
Proficient organizational skills
Excellent writing and communication skills
Ability to prioritize and manage time effectively
Proficient in Microsoft Office products such as Outlook, Word and Excel
Knowledge of HIPPA guidelines
Regular and prompt attendance
Ability to work schedule as defined and overtime as required
Related duties as required
Qualification
Required
Associates degree in a related field from an accredited institution as approved and accepted by the University of South Alabama
Four years of coding collections or denial management experience in a hospital/clinical setting
Experience with Cerner Millennium
Demonstrated knowledge of hospital billing and reimbursement
Knowledge of denials and appeals
Knowledge of federal and state regulations governing the health care industry
Excellent critical thinking and analytical skills
Attention to detail and ability to complete the job with minimal errors and to work independently
Proficient organizational skills
Excellent writing and communication skills
Ability to prioritize and manage time effectively
Proficient in Microsoft Office products such as Outlook, Word and Excel
Knowledge of HIPPA guidelines
Regular and prompt attendance
Ability to work schedule as defined and overtime as required
Company
USA Health
USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Candice Powers, MBA, CRCR, CRCA
Chief Revenue Officer (CRO)
Sherry Fryman
Chief Nursing Officer
Recent News
Charleston Business
2025-06-27
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