Denials Analyst - Billing Department

Job Description

The Western Region Consolidated Business Office provides business office services including billing, collections, cash posting, pre‑access management, variance and customer service to our affiliated UHS facilities. We are seeking dynamic and talented individuals to join our team.
Job Description: Handles and manages Medicare RAC and QIO correspondences thru Cobius Audit Manager, responsible for all incoming correspondences from MAC/CMS, maintains inventory sent to the Vendor for appeals, works with the Vendor in obtaining additional information needed to file appeals, works with the clinical team/vendor for Medicare 1‑day stay review, manages Medicare denials in Artiva for medical necessity review, responsible to coordinate with the Vendor on all Transfer DRG corrections, and works with HIM to resolve LCD/NCD edits on claims.

• Handles and manages Medicare RAC and QIO correspondences thru Cobius Audit Manager
• Responsible for all incoming correspondences from MAC/CMS
• Maintains inventory sent to Vendor for appeals
• Works with Vendor in obtaining additional information needed to file appeals
• Works with clinical team/vendor for Medicare 1‑day stay review
• Manages Medicare denials in Artiva for medical necessity review
• Responsible to coordinate with Vendor on all Transfer DRG corrections
• Works with HIM to resolve LCD/NCD edits on claims

High school diploma or equivalent.

2 years healthcare/collection experience and/or equivalent experience in a hospital setting. Minimum of 2 years of previous Collections/Appeals experience.

• Strong analytical, organizational, communication, and problem‑solving skills, as well as a thorough understanding of the denial/appeals process.
• Computer proficiency to include word processing, spreadsheet, database, and patient accounting system.

Demonstrated knowledge of insurance billing relating to patient reimbursement. Must be able to identify trends or patterns in denial reasons and provide feedback to leadership to improve processes and reduce future denials.

• Challenging and rewarding work environment
• Growth and Development Opportunities within UHS and its subsidiaries
• Competitive Compensation
• Excellent Medical, Dental, Vision and Prescription Drug Plan
• k plan with company match