Collections Analyst, Virtual

4 weeks ago


Gainesville FL, United States UF Health Shands Full time

The Enterprise Denial Analyst is responsible for reviewing technical denial claims, submitting reconsiderations or appeals. Reporting to the Enterprise Technical Denial Assistant Manager this role is responsible to optimize the financial outcomes of the hospital-based revenue cycle through maintaining a low denial rate and high reimbursement rate at an enterprise level for UF Health. Initiates a root cause analysis of denied payment through comprehensive means including but not limited to: research of patient stays and treatment, review of payer contracts, analysis of historical denials, appeals and their outcomes, emerging trends in payer practices and requirements. Works to maintain third-party payer relationships, including responding to inquiries, complaints and other correspondence. Working in conjunction with the Enterprise Technical Denial Assistance Manager and Enterprise Sr Denial Manager, maintains a strong working relationship with the Enterprise Managed Care Department to escalate and resolve atypical denial issues. The enterprise denial analyst is considered a technical denial expert in denial management and ensures all denied claims are accurately worked from a technical/ billing perspective. Working in collaboration with the different revenue cycle departments through the enterprise to establish best practice solutions to maximize reimbursement and minimize organizational write-offs.
High school graduate required and four (4) years coding or billing, insurance follow up, collections or denial management in a hospital /clinical setting.
Prefer Associates degree or higher in a health or business-related field and 3 years coding or billing, insurance follow up, collections or denial management in a hospital /clinical setting.
o Hospital billing and reimbursement
Excellent writing and communication skills
Proficient in Microsoft Office Products such as Outlook, Word, Excel
High level of comfort with computer systems
Licensure/Certification/Registration:


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