Payer Integrity Clinical Analyst

23 hours ago


Lexington, Kentucky, United States InsideHigherEd Full time
Payer Integrity Clinical Analyst

We are seeking a highly skilled Payer Integrity Clinical Analyst to join our team. The ideal candidate will have extensive knowledge and experience in third-party payer denials and completing denial appeals.

Key Responsibilities:
  • Ensure accurate reimbursement for clinical services performed through resolution of denied claims for UKHC
  • Utilize analytical and critical-thinking skills to resolve complex reimbursement issues
  • Develop and implement effective denial appeal strategies to minimize financial losses
  • Collaborate with cross-functional teams to identify and address reimbursement-related issues
Requirements:
  • Associate degree in Nursing and at least three full years of related healthcare employment experience
  • Extensive knowledge and experience in third-party payer denials and completing denial appeals
  • Proficient understanding of the Revenue Cycle process and managed care contracts
  • Strong analytical, critical-thinking, problem-solving, time management, follow-through, and planning and organizational skills
Preferred Qualifications:
  • Experience with and knowledge of Microsoft Office, specifically the applications Word, Outlook, PowerPoint, and Excel
  • In-depth HIPAA knowledge and medical, financial, and contractual terminology
  • Proficient knowledge of medical coding (ICD-10, HCPCS, CPT)
What We Offer:
  • A competitive salary and benefits package
  • A dynamic and supportive work environment
  • Opportunities for professional growth and development


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