AdventHealth · 11 hours ago
Denials Management Prevention Analyst
Maitland, FL
Full-time
Onsite
Mid, Senior Level
$50K/yr - $92K/yr
5+ years expAdventHealth is a community-focused organization dedicated to uplifting individuals in body, mind, and spirit. The Denials Management Prevention Analyst will collect, analyze, and report data to support denials management operations and prevention projects, while also coordinating training and communication across departments.
Health CareHospitalOnline Portals
Responsibilities
Collects, analyzes, and reports data for insights into denials management operations and special prevention projects
Communicates and presents insights and recommendations to the denials management committee on prevention activities
Coordinates material and provides updates for key denials prevention program documentation
Reviews managed care contracts and compares them against patient claims to identify and prevent claim underpayments
Provides feedback to managed care on identified underpayment issues for remediation with the payor
Tracks payer audit requests and monitors adherence to contractual terms, communicating violations to the managed care contract team
Leads denials management prevention projects by gathering and analyzing data to support process improvement
Develops and maintains up-to-date denials management staff job aides, training materials, and playbooks
Onboards and continuously trains denials management staff on workflow, technology, policies, and procedures
Travels to individual facilities or business offices as needed to conduct trainings, provide operational support, and attend meetings
Communicates and coordinates with various individuals and departments to assist with monitoring claims prevention activities
Strives to meet and exceed productivity and quality expectations, escalating concerns or difficulties in a timely manner for management action
Performs other duties as assigned
Qualification
Required
Strong keyboard and 10 key skills
Proficiency in Microsoft Suite applications, specifically Excel and Word applications, as well as Outlook
Strong quantitative, analytical and organization skills
Strong problem solving skills
Proficiency in data warehousing and business intelligence platforms
Ability to understand insurance terms and payment methodologies
Ability to navigate accounts to perform research and gather additional information to identify root causes
Interpersonal skills to promote teamwork throughout the denials management team
Ability to multitask and function in a fast-paced environment
Ability to communicate effectively in written and oral form with diverse populations
Have a good understanding of insurance reimbursement related to all payers including but not limited to Government, Medicaid, Medicaid HMO products (i.e. VA, Tricare, Crimes Comp, Prisoners, etc.) and Managed Care / Commercial products
Uses discretion when discussing personnel/patient related issues that are confidential in nature
High School Grad or Equiv
5+ years related experience
Preferred
SQL experience
Ability to translate user requirements into functional & design specifications
Comfort with interpreting clinical documentation and medical record to identify improvement opportunities to prevent future denials
Experience in Billing, A/R follow up and denials management functions
Prior reporting and analytics background
Benefits
Medical, Dental, Vision Insurance
Life Insurance
Disability Insurance
Paid Time Off from Day One
403-B Retirement Plan
4 Weeks 100% Paid Parental Leave
Career Development
Whole Person Well-being Resources
Mental Health Resources and Support
Pet Benefits
Company
AdventHealth
AdventHealth is a nonprofit healthcare system providing whole-person care through hospitals, clinics, and virtual services.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
$0.25MKey Investors
Florida Blue FoundationKentucky Opioid Abatement Advisory Commission
2025-09-15Grant
2023-10-05Grant· $0.25M
Leadership Team
Clifton Scott
COO Flagler | St. Johns Market
Bela Nand
Chief Medical Officer
Recent News
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