Immediate Hiring For AR Analyst - Night Shift - Oncospark

Job Description

Job Summary : The Denial Management Analyst is responsible for identifying, analyzing, and resolving denied or rejected medical claims. The role involves working with insurance companies, healthcare providers, and internal teams to appeal denied claims, reduce denial rates, and ensure timely and accurate reimbursement. Key Responsibilities: Analyze Explanation of Benefits (EOBs), Electronic Remittance Advices (ERAs), and denial codes to understand the reasons for claim denials. Categorize denials and identify trends (e.g., eligibility, authorization, coding, timely filing). Initiate and follow up on appeals and reconsiderations with payers as per payer-specific guidelines. Collaborate with billing, coding, and AR teams to resolve claim issues and refile corrected claims. Maintain accurate documentation of denial resolution activities in the billing system. Monitor and report on key denial metrics including denial rate, recovery rate, and appeal success rate. Escalate recurring issues to management with data-driven insights. Ensure adherence to HIPAA regulations and company compliance policies. Meet individual and team productivity and quality benchmarks. Requirements: Bachelors degree (preferred) or equivalent experience in RCM or healthcare billing. Minimum 1–2 years of experience in denial management or claims processing. Strong understanding of medical billing, CPT/ICD codes, and insurance guidelines (Medicare, Medicaid, Commercial). Experience with payer portals and denial management tools. Knowledge of claim adjudication process and appeal filing formats. Excellent problem-solving and communication skills. Proficient in MS Excel and billing software (e.g., Kareo, Athena, AdvancedMD, etc.)