Mary Free Bed Rehabilitation Hospital · 19 hours ago
Denial Prevention Analyst
Grand Rapids, MI
Full-time
Onsite
Mid Level
3+ years expMary Free Bed Rehabilitation Hospital is a not-for-profit, nationally accredited rehabilitation hospital dedicated to helping patients and families rebuild their lives. The Denial Prevention Analyst is responsible for analyzing denials and appeals, optimizing reimbursement, and collaborating with various departments to resolve claim issues.
Health CareHospital
Responsibilities
Reviews explanation of benefits and benefits coverage to determine the best course of action. If needed for further clarification, contact insurance carrier
Analyzes denial trends for staff/organizational education purposes
Research online medical bulletins and policies, pricing and contractual issues
Reviews clinical documentation, coding and claim to determine if the times and services provided to patients were applied correctly
Prepares and mails written rationale of claim reconsideration request
Tracks all denials within a database for reporting
Maintains appropriate established timelines for follow up on outstanding appeal/reconsideration requests
Collaborates with other Revenue Cycle Management and clinical departments to resolve claim issues as needed
Any other duties as assigned
Demonstrate excellent customer service and standards of behaviors as well as encourages, coaches, and monitors the same in team members
Contribute by identifying problems and seeking solutions. Promote patient/family satisfaction where possible; participates in departmental efforts to monitor and report customer service
Qualification
Required
Associates Degree and a minimum of 3 years' experience in healthcare denial prevention. Knowledge of payer benefit policies and utilization review experience
Possesses a high level of initiative, self-directed, highly motivated and analytically minded
Comprehension of healthcare terminology
Time management skills to handle multiple, competing demands and priorities, and work effectively under pressure
Strong, effective organization and interpersonal skills
Superior written communication skills, including ability to write well organized, concise payer appeals
Collaborative team style and open communication, including with other departments
Excellent analysis and problem solving skills
Demonstrated commitment to organizational mission with a “whatever it takes” attitude to get the job done
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint)
Excellent computer knowledge and use of appropriate Electronic Medical Records, Admissions, and Utilization Management applications
Preferred
IRF medical billing experience
Knowledge of ICD-9-CM and CPT coding classification systems
Company
Mary Free Bed Rehabilitation Hospital
Mary Free Bed Rehabilitation Hospital is a rehabilitation system that provides doctors and rehab professionals has cared for patients.
1001-5000 employees
H1B Sponsorship
Mary Free Bed Rehabilitation Hospital has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2020 (1)
Funding
Current Stage
Late StageTotal Funding
$3M2023-01-07Grant· $3M
Leadership Team
Kent Riddle
CEO
Ryan Podvin
Chief Financial Officer
Recent News
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