DENIAL MANAGEMENT ANALYST (225542)

<strong>To heal, to teach, to discover and to advance the health of the communities we serve.<br /></strong><br /> <p>To learn more about the &ldquo;Montefiore Difference&rdquo; &ndash; who we are at Montefiore and all that we have to offer our associates, please click <strong><a href="https://healthymebenefits.com/" target="_blank" title="Montefiore Difference" rel="noopener noreferrer">here</a></strong>.&nbsp;</p>

Bronx, New York

Montefiore

<h4 class=""><strong>WHY TOP TALENT PICKS MONTEFIORE EINSTEIN&nbsp;<br /><br /></strong>Since its inception in 1884, Montefiore Einstein&rsquo;s mission has been to heal, to teach, to discover and advance the health of the communities we serve.<br /><br />Montefiore Einstein&rsquo;s state-of-the-art facilities include the&nbsp;<span class="">internationally-recognized</span>&nbsp;Children&rsquo;s Hospital at Montefiore Einstein and our Notable Centers of Excellence - Montefiore Einstein Center for Cancer Care, Montefiore Einstein Center for Heart and Vascular Care, Montefiore Einstein Center for Transplantation. Combined with a growing number of locations throughout the Bronx and Westchester County, Montefiore Einstein is the ideal organization to apply and hone your expertise.<br /><br /><span style="text-decoration: underline;"><a href="https://montefiore.wd12.myworkdayjobs.com/en-US/MMC/login" target="_blank" title="Candidate Home" rel="noopener noreferrer">Sign In</a></span>&nbsp;- Candidate Home<br /><span style="text-decoration: underline;"><a href="https://montefiore.wd12.myworkdayjobs.com/en-US/MMC/introduceYourself" target="_blank" title="Introduce Yourself " rel="noopener noreferrer">Introduce Yourself&nbsp;</a></span>-&nbsp;Please let us know about yourself so we can keep in touch about future job openings!<br /><br /><strong><span class="">NURSE&nbsp;RECRUITMENT&nbsp;HOTLINE:</span>&nbsp;<span class="">718-920-6697 (</span><span class="">Monday-Friday: 9am-4pm)&nbsp;&nbsp;</span></strong><br /><br /><strong>Check Out Our Employee&nbsp;<span style="text-decoration: underline;"><a href="https://healthymebenefits.com/" target="_blank" title="Benefits" rel="noopener noreferrer">Benefits</a></span></strong></h4> <h4 class="p1"><span style="text-decoration: underline;"><strong><a href="https://s3.us-east-1.amazonaws.com/vizi.vizirecruiter.com/MontefioreHealthSystem+RecruitingPractices.pdf" target="_blank" title="Safe Online Recruiting" rel="noopener noreferrer">Our Commitment to Safe Online Recruiting</a></strong></span></h4> https://www.montefiore.org/

keywords: summary,analysis,education & experience,knowledge,skills

Full time

$49,920.00-$62,400.00 annually*

Overview: <p><strong>City/State:</strong></p> Bronx, New York <p><strong>Grant Funded:</strong></p> No <p><strong>Department:</strong></p> NoMgr <p><strong>Work Shift:</strong></p> Day <p><strong>Work Days:</strong></p> MON-FRI <p><strong>Scheduled Hours:</strong></p> 8:30 AM-5 PM <p><strong>Scheduled Daily Hours:</strong></p> 7.5 HOURS <p><strong>Pay Range:</strong></p> $49,920.00-$62,400.00
Responsibilities: Researches and analyzes denials on a daily basis, identifies root causes, and processes resubmissions/appeals with the goal of overturning the denial and getting paid by the insurance carrier, maximizing revenue for the division.
Requirements: <ul> <li>Three to five years of progressive experience in appeal/denial management.</li> <li>Preferred Strong knowledge of health plan requirements.</li> <li>Strong analytical, statistical analysis skills required.</li> <li>Strong knowledge of EPIC, Microsoft Excel, Word and PowerPoint skills required.</li> <li>Knowledge of federal, regional and state payer coverage patterns (CMS, fiscal intermediary, and Administrative).</li> <li>Strong organizational and communication skills; professionalism, able to work with all levels of staff.</li> <li>Bachelor's Degree preferred (Certified Professional Coder (CPC)).</li> <li>Associate Degree required (Medical Billing experience).</li> <li>Certified Professional Coder (CPC) required.</li> <li>EPIC Cadence, HB, PB certifications preferred.</li> <li>Knowledge of CPT coding and ICD10 diagnosis required.</li> <li>Ability to work and effectively multi-task in a fast-paced clinic environment with patients with developmental disabilities.</li> </ul>