Syracuse Community Health · 7 hours ago
Denials Management & Reconciliation Analyst
Syracuse, NY, US
Full-time
Hybrid
Senior Level
$75K/yr - $82K/yr
5+ years expSyracuse Community Health is seeking a Denials Management & Reconciliation Analyst to manage claims processing and electronic payments. The role involves collaborating with various stakeholders to minimize denials and ensure compliance with billing regulations.
Addiction TreatmentHealth CareHospitalMedical
Responsibilities
Processing of claims, posting electronic payments, claim adjustments, and review of non-coding related denials while working closely with patients, front desk staff and insurance carriers to ensure optimal submission and payment for all billable visits
Requires expertise in healthcare billing, coding, electronic remittances and insurance policies to identify root causes of rejections, denials, appeal incorrect decisions, and implement strategies to minimize future denials
Works with software vendors and insurance companies to streamline and resolve issues identified throughout the claims process
Collaborates on performance improvement initiatives focused on coding, billing regulations, and coding standards such as ADA/CPT-4, HCPCS and ICD-10-CM
Coordinate with Medical Staff and coders for accurate charge capture and coding
Analyze clean claims rate, denials, days in AR, and recommend opportunities to the Director of Revenue Cycle
Investigates non-coding insurance denials and identifies and implements best-recommended action via feedback/reports to Director of Revenue Cycle Management
Understands and adheres to each insurance carrier’s claim submission guidelines
Makes necessary corrections to patient accounts for accurate electronic submission
Determines need for third party insurance payer appeal and sends individual appeal letters
Monitors appeals for resolution
Research, review and communicate with insurance carriers regarding open accounts receivable
Ensure compliance with company and regulatory standards
Prepare reports and presentations for quarterly departmental meetings
Assist with education and training for providers and front desk staff to ensure appropriate cash collection
Reports onsite for onboarding and orientation. Will consider hybrid schedule thereafter
Qualification
Required
Bachelor's Degree in relevant field
5-7 years of progressive, advancing, revenue cycle/medical billing experience
Equivalent combination of education, training, certification and progressive advanced experience in a healthcare setting
Experience preferably in an Ambulatory Care, Outpatient facility operating in New York State
Expertise in healthcare billing, coding, electronic remittances and insurance policies
Ability to identify root causes of rejections and denials
Experience in appealing incorrect decisions and implementing strategies to minimize future denials
Ability to work with software vendors and insurance companies to streamline and resolve issues
Collaboration on performance improvement initiatives focused on coding, billing regulations, and coding standards such as ADA/CPT-4, HCPCS and ICD-10-CM
Coordination with Medical Staff and coders for accurate charge capture and coding
Ability to analyze clean claims rate, denials, days in AR, and recommend opportunities
Investigation of non-coding insurance denials and implementation of best-recommended actions
Understanding and adherence to each insurance carrier's claim submission guidelines
Ability to make necessary corrections to patient accounts for accurate electronic submission
Determination of need for third party insurance payer appeal and sending individual appeal letters
Monitoring appeals for resolution
Research, review and communication with insurance carriers regarding open accounts receivable
Ensuring compliance with company and regulatory standards
Preparation of reports and presentations for quarterly departmental meetings
Assistance with education and training for providers and front desk staff to ensure appropriate cash collection
Company
Syracuse Community Health
Syracuse Community Health provides dental, eye care, pharmacy, psychiatric and addiction treatment, telehealth, and women’s health services.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Jessica Y.
Chief Operating Officer
Keith Cuttler
Chief Operating Officer
Recent News
Central New York Business Journal
2025-05-31
Central New York Business Journal
2024-12-06
2023-12-10
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