RCM Denial Claims Analyst Lead

2 months ago


West Long Branch, United States Allied Digestive Health Full time
Allied Digestive Health is one of the largest integrated networks of gastroenterology care centers in the nation with over 200 providers and 60 locations throughout New Jersey and New York. As a fast-growing physician-led organization, our dynamic structure encourages physician input and decision-making, while simultaneously offering operational support. Our dedicated, compassionate team of providers prioritize personalized treatment plans for patients that deliver the highest quality of care. All of our doctors are board-certified in gastroenterology and hepatology. Several of them serve as chief of gastroenterology at nearby hospitals, and a number of them have been recognized as top-quality physicians in publications, including but not limited to: Best Doctors in America and Top Doctors New Jersey, and US News Health - US News & World Report.

We are excited to announce that we are looking for a Fulltime AR Denials and Escalation Analystat our Corporate office in West Long Branch NJ.

This position can be remote or hybrid

The AR Denials and Escalation Analyst responsibilities are
  • Conducting medical coding audits to evaluate compliance with regulatory guidelines.
  • Conducts coding, billing, and documentation compliance audits within established timeframe. Identifies need for new policy development/changes to meet regulatory requirements..
  • Prepares a report of findings and recommendations for improvement for each audit.
  • Serves as a subject matter expert on coding/billing topics

The AR Denials and Escalation Analyst must have the following qualifications and experience:
  • 3+ years of relevant experience in a professional audit capacity required. Must have CPC, CRC, CGIC, CGOC from AAPC
  • Strong technical knowledge of Institute of Internal Auditing (IIA) standards and Centers for Medicare & Medicaid Services (CMS) regulatory guidelines, including ICD-10 CM, CPT, and HCPCS Procedure Coding
  • Proficiency in MS Office products - intermediate to advanced knowledge of MS Excel.
  • Knowledge of Denials and Escalation


Job Type: Fulltime

  • West Long Branch, United States Allied Digestive Health Full time

    Job DescriptionAllied Digestive Health is one of the largest integrated networks of gastroenterology care centers in the nation with over 200 providers and 60 locations throughout New Jersey and New York. As a fast-growing physician-led organization, our dynamic structure encourages physician input and decision-making, while simultaneously offering...


  • West Long Branch, United States Allied Digestive Health Full time

    Job DescriptionJob DescriptionAllied Digestive Health is one of the largest integrated networks of gastroenterology care centers in the nation with over 200 providers and 60 locations throughout New Jersey and New York. As a fast-growing physician-led organization, our dynamic structure encourages physician input and decision-making, while simultaneously...


  • West Bend, Wisconsin, United States PT Plus Full time

    Job DescriptionWe are seeking a skilled Medical Claims Coordinator to join our team at PT Plus. This role plays a crucial part in ensuring the fiscal health and compliant process of our revenue cycle management. As a Medical Claims Coordinator, you will be responsible for monitoring, tracking, and responding to claim denials, reporting weekly on denial...


  • Long Beach, United States TheBest Claims Solutions Full time $40 - $45

    Our client, is in need of a Temporary Workers' Compensation Claims Examiner for their Long Beach Office to work on a remote basis. The ideal candidate will have 3+ years of California Workers Compensation Experience.Is this your next job Read the full description below to find out, and do not hesitate to make an application.Required Qualifications:3+ years...


  • Long Beach, United States TheBest Claims Solutions Full time

    Our client, is in need of a Temporary Workers' Compensation Claims Examiner for their Long Beach Office to work on a remote basis. The ideal candidate will have 3+ years of California Workers Compensation Experience.Is this your next job Read the full description below to find out, and do not hesitate to make an application.Required Qualifications:3+ years...


  • Long Beach, California, United States Advanced Medical Manage Full time

    Job DescriptionCompany OverviewAdvanced Medical Manage is a leading healthcare management company seeking an experienced Healthcare Claims Processing Lead to join our team.Estimated Salary:$80,000 - $110,000 per yearJob SummaryWe are looking for a skilled and detail-oriented Healthcare Claims Processing Lead to oversee the claims processing workflow and...


  • West Long Branch, New Jersey, United States Allied Digestive Health Full time

    Allied Digestive Health is a leading gastroenterology care network with over 200 providers and 60 locations across New Jersey and New York. We are seeking an experienced RCM Billing Manager to join our dynamic team in West Long Branch.We offer a competitive base salary of $80,000 - $100,000 per year, along with generous benefits, including medical, dental,...


  • West Palm Beach, Florida, United States Dane Street, LLC Full time

    Job DescriptionDane Street, LLC is a fast-paced company that processes over 200,000 insurance claims annually for leading national and regional Workers' Compensation, Disability, Auto and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers and Pharmacy Benefit Managers.We provide customized Independent Medical Exam and...


  • West Columbia, South Carolina, United States Auto-Owners Insurance Full time

    A career at Auto-Owners Insurance is challenging and rewarding. As a top-rated insurance carrier, we create financial security by helping individuals and businesses make a new start when a loss occurs.Job Description:The position of Claims Representative Intern requires a motivated individual to join our team for the summer. The role involves investigating...


  • West Long Branch, New Jersey, United States Allied Digestive Health Full time

    Allied Digestive Health is a leading gastroenterology care network with over 200+ providers and 60+ locations in New Jersey and New York. As a fast-growing physician-led organization, we prioritize personalized treatment plans and deliver the highest quality of care.We are seeking a Full-Time RCM Regional Patient Access Specialist to supervise front-end...


  • Long Beach, California, United States United Pacific Full time

    About the RoleUnited Pacific, a leading gasoline and convenience store retailer, is seeking an experienced Insurance Claims Coordinator to oversee the Incident Reporting and Claims process. As a key member of our team, you will be responsible for achieving early claim resolution and avoiding litigation in a cost-effective and time-efficient manner.In this...


  • West Columbia, South Carolina, United States Auto-Owners Insurance Full time

    Auto-Owners Insurance Overview">We are a top-rated insurance carrier offering a challenging and rewarding career path for our associates.Salary$16.00 per hour, with potential for higher pay rates for returning interns.Job DescriptionThis internship requires investigating facts, determining policy coverage, evaluating losses, and analyzing liability to ensure...


  • Long Beach, CA, United States TheBest Claims Solutions Full time

    Job Summary: TheBest Claims Solutions is seeking a Remote Insurance Claims Professional to handle workers' compensation claims in California. This exciting opportunity allows you to work from home and leverage your expertise to drive successful claims outcomes.Responsibilities: In this role, you will:Process and manage workers' compensation claims in...


  • Long Beach, United States Blue Shield of CA Full time

    Your Role The Self-Funded Finance team who handles the claims billing for all Self-Funded groups. The Financial Analyst, Experienced will report to the Self-Funded Finance Manager. In this role you will be Assisting with Group set ups from implementation to go live. Assist with ad-hoc reporting and various Self-Funded projects. Assist with department audits,...

  • Assoc Analyst, Data

    7 days ago


    Long Beach, United States Molina Healthcare Full time

    JOB DESCRIPTION Job Summary Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and...


  • Long Beach, CA, United States Blue Shield of California Full time

    Your Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...

  • Assoc Analyst, Data

    4 weeks ago


    Long Beach, United States Molina Healthcare Full time $21 - $40

    JOB DESCRIPTION Job Summary Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and...

  • Assoc Analyst, Data

    4 weeks ago


    Long Beach, United States Molina Healthcare Full time $21 - $40

    JOB DESCRIPTION Job Summary Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and...


  • Farmers Branch, Texas, United States Fay Financial Full time

    Job DescriptionFay Financial is seeking an experienced Senior Data Science Analyst to join our team in New York City. As a Senior Data Science Analyst, you will be responsible for transforming data into actionable insights that drive strategic decision-making across the organization.The ideal candidate will have 5+ years of experience in data science,...

  • Behavior Analyst Lead

    2 weeks ago


    Long Beach, California, United States United Therapy Center Full time

    Job OverviewWe are seeking a passionate and dedicated Board Certified Behavior Analyst (BCBA) to lead our team in Los Angeles, CA.Salary: $65/hourAbout the RoleThe BCBA will play a pivotal role in designing, implementing, and supervising ABA therapy programs tailored to meet the unique needs of each individual client.Key Responsibilities:Oversee applied...