DENIAL MANAGEMENT ANALYST

Researches and analyzes denials on a daily basis, identifies root causes, and processes resubmissions/appeals with the goal of overturning the denial and getting paid by the insurance carrier, maximizing revenue for the division. Qualifications Three to five years of progressive experience in appeal/denial management - Preferred Strong knowledge of health plan requirements Strong analytical and statistical analysis skills Proficiency in EPIC, Microsoft Excel, Word, and PowerPoint Knowledge of federal, regional, and state payer coverage patterns (CMS, fiscal intermediary, and Administrative) Strong organizational and communication skills; professionalism; ability to work with all levels of staff Bachelor's Degree preferred (Certified Professional Coder - CPC) Associate's Degree required (Medical Billing experience) Certified Professional Coder (CPC) required EPIC Cadence, HB, PB certifications preferred Knowledge of CPT coding and ICD-10 diagnosis required Ability to work and effectively multi-task in a fast-paced clinic environment with patients with developmental disabilities Position Details Department: Pediatrics Bargaining Unit: Non Union Campus: MOSES Employment Status: Regular Full-Time Address: 1225 Morris Park Avenue, Bronx Shift: Day Scheduled Hours: 8:30 AM - 5 PM Req ID: 225542 Salary Range/Pay Rate: $62,400.00 - $78,000.00 Additional Information For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education, or other relevant factors. To learn more about the "Montefiore Difference" - who we are at Montefiore and all that we have to offer our associates, please click here. Montefiore is an equal employment opportunity employer. We recruit, hire, train, transfer, promote, layoff, and discharge associates in all job classifications without regard to race, color, religion, creed, national origin, alienage or citizenship status, age, gender, disability, sexual orientation, gender identity, genetic information, pregnancy, military status, marital status, or any other characteristic protected by law. #J-18808-Ljbffr

Created: 2025-09-17