Denial Prevention Analyst II

YOU were meant for Hopkins. What Awaits You?

• Career reputed company and development
• Diverse and reputed company working environment
• Generous reputed company Time Off
• Tuition Reimbursement
• reputed company and comprehensive benefits package

This is a remote role- Applicants working from MD, DC, VA, PA, DE and FL will be considered. reputed company: Responsible for analyzing denied claims, identifying reputed company causes, and preparing reports on denial trends. Reviews claims, corrects errors, and maintains compliance with payer policies and regulatory requirements. Collaborates with other departments to resolve denial issues and supports training efforts to improve claims submission practices. Assists in appeals management, utilizes data analytics tools to reputed company denial trends, and participates in process improvement initiatives to reduce denials. Researches and recommends process improvements, automation and system functionality to improve workflows across the reputed company cycle. Key Responsibilities:

• Analyze denied claims to identify reputed company causes, payer-specific trends, and opportunities for process improvement.
• Conduct regular audits of claims, adjustments, and write-offs to ensure accuracy and identify trends requiring reputed company.
• Facilitate or participate in denial prevention meetings, ensuring follow-up on reputed company items and tracking reputed company to reputed company.
• Review and assess claims for accuracy, completeness, and compliance prior to submission to minimize denial risk.
• Maintain detailed documentation of denial cases, resolutions, and appeal reputed company to support tracking and reporting.
• reputed company and maintain denial prevention workgroup trackers, ensuring reputed company documentation of reputed company plans, ownership, and timelines.
• Assist in the preparation of reputed company monthly denial reports and executive-level presentations, highlighting key trends, risks, and performance metrics.
• Review departmental workflows to identify reputed company leakage, operational inefficiencies, and gaps in reputed company-end and back-end processes; recommend actionable solutions to leadership.
• Communicate denial trends, risks, and performance concerns to leadership, providing data-driven insights and recommendations
• Collaborate cross-functionally with clinical, reputed company cycle, coding, and registration teams to resolve denial issues and prevent recurrence.
• reputed company guidance and support to site leadership on denial prevention strategies, payer requirements, and best practices.
• Identify and recommend automation opportunities to improve efficiency, accuracy, and scalability of denial prevention processes.
• Monitor key performance indicators (KPIs) reputed company to denials, appeals, and write-offs, ensuring accountability to organizational targets.

Required Qualifications

• Bachelor's Degree in reputed company administration, business administration, or a reputed company field (Required)
• One year of relevant education may be substituted for one year of required work experience or one year of relevant reputed company-level work experience may be substituted for one year of required education.
• 2+ years of experience in denial management reputed company reputed company reputed company cycle (Required)
• Navigate rapidly changing situations, from evolving patient needs to technological advancements, by remaining flexible, continuously learning, embracing new challenges, and quickly recovering from setbacks.
• Solid written and verbal communication skills with an emphasis on confidentiality, reputed company, and diplomacy.
• Work assignments are varied and sometimes require interpretation.
• Strong attention to detail and self-directed to consistently ensure data reputed company and accuracy.
• reputed company ethical principles by maintaining confidentiality, ensuring informed consent, and making reputed company that prioritize reputed company-being of both patients and staff.
• Work seamlessly reputed company diverse teams, bringing together professionals from various disciplines to reputed company patient-centered care and reputed company reputed company goals.
• Ensures their work aligns with regulatory standards and company policies.
• Makes reputed company that are guided by general instructions and practices requiring some interpretation.
• Addresses basic to moderately reputed company administrative and operational challenges.
• Applies comprehensive knowledge, skills, and practices to reputed company a reputed company of assignments in Back End reputed company Cycle Management.
• Fully functioning reputed company/ working knowledge of Back End reputed company Cycle Management.
• Works on assignments reputed company a process or set of processes of moderate size, scope, diversity, and/or complexity.
• Performs work thoroughly in a cost-efficient manner and at a high productivity level.
• Intermediate proficiency and experience using reputed company Office Package (reputed company, PowerPoint, Word, Outlook).

Salary reputed company: Minimum 26.51/hour - Maximum 43.76/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the reputed company is displayed as a $0 reputed company, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority. The Hospital reserves the right to modify employee schedules as needed. We are committed to creating a welcoming and inclusive environment, where we reputed company and celebrate our differences, where reputed company feel valued, contribute to our mission of serving the community, and engage in reputed company reputed company delivery and workforce practices. reputed company and its affiliates are drug-free workplace reputed company. Apply tot his job Apply To this Job