Denials Management Analyst

Responsible for the collection and reconciliation of underpayments on managed care contracts. Maintains a log of the current status of underpayments collected. Maintains and continually updates the department training manual. Provides a weekly and a monthly report of collections to the Manager. Responsible for completion of projects that are pro-active and focused on problem areas and high cost services to ensure maximum contractual reimbursement. Responsible for understanding the reimbursement methods by contract and knowledge of PMMC for contract management reporting. Responsible for developing a strong relationship with insurance carriers in order to address multiple underpayments by a given payer.

• Require a minimum of five (5) years of collections or healthcare-related experience within a HB healthcare setting.

• Higher level candidate - handling mostly insurance appeals.

• Insurance background is a must and they need to be able to work independently (no manager standing over you). No customer service side to it, clinical background can be valuable as well. nurses work in that area as well.

• Prefer demonstrated analytic skills.

• Prefer demonstrated computer skills in spreadsheet database, word processing, PMMC and any other applications.

• Prefer strong interpersonal skills, including the ability to handle difficult situation in a diplomatic manner.

Medix is acting as an Employment Agency in relation to this vacancy.