Catawba Valley Health System · 16 hours ago
Denials Analyst / Utilization Review / Full Time
North Carolina, United States
Full-time
Onsite
Entry Level
1+ years expCatawba Valley Health System is a not-for-profit community hospital dedicated to providing accessible healthcare services. The Denials Analyst position involves reviewing, researching, and resolving denied claims, as well as reprocessing claims and submitting appeals, requiring strong analytical skills and knowledge of billing regulations.
Health CareHospitalMedicalRehabilitation
Responsibilities
Working with various internal and external customers regarding review, research, and resolution of denied claims
Reviewing accounts and taking appropriate actions based on type of denial and department procedure
Responsible for reprocessing claims, submitting appeals, and performing claim adjustments
Analyzing denial and adjustment trends
Working within contract language and understanding healthcare reimbursement methodologies and language
Spending majority of time working within Meditech, payer websites, RCW, Microsoft Excel, performing data analysis, tracking, trending, and research
Qualification
Required
Associates degree or relevant experience in utilization review or finance/revenue cycle, working denials, managed care contracting, or payor relations
Must possess a strong understanding of revenue cycle and managed care operations
Strong to advanced Microsoft Excel and analytical skills required
Intermediate level of Microsoft Word and PowerPoint
One year of applicable experience, if candidate has no experience, they must have completed a successful healthcare internship in Utilization Review and/or finance, revenue cycle, medical billing, or denial management
Knowledge of healthcare reimbursement with a familiarity of CPT codes, DRGs, ICD-9s, & billing methodology for hospitals and physician practices
An understanding of managed care contracts and experience in working denials and appeals is helpful
Demonstrated experience in problem-solving, critical thinking, accomplishing tasks on assigned timelines, and evidence of sound judgement
Excellent PC, Excel skills and ability to learn and use new software applications is important
Excellent communication and customer service skills
Given experience and on-the job training, incumbent should be proficient in the basic aspects of the position in three months of employment date
Company
Catawba Valley Health System
Catawba Valley Health System is the region's largest not-for-profit community hospital, it is our mission to improve the health status of the Catawba Valley.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Kimberly Crews
Vice President of Finance/Chief Financial Officer
Pamela J. Gallagher, CPA, DBA
Chief Financial Officer
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