Denials Analyst

 About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

JOB SUMMARY:

The Denials Analyst is responsible for managing the denials reporting process, identifying and tracking trends in denials, and collaborating with internal and client leadership to resolve underlying issues. This role plays a key part in identifying process gaps and developing workflows, policies, and reporting tools to reduce future denials, optimize revenue cycle processes, and accelerate cash flow.
MUST HAVE:
Denial reporting, claims rejection experience
IL Medicaid knowledge strongly preferred
Hospital Billing experience strongly preferred
SQL experience preferred
HYBRID - Chicago, IL

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

• Oversee and manage the daily, weekly, and monthly denials reporting.
• Analyze and identify trends in denials across various clients and service lines.
• Work closely with internal teams and client leadership to investigate root causes of denials.
• Collaborate with key stakeholders to identify process gaps contributing to denials and work on corrective action plans.
• Develop and implement workflows, policies, and best practices to prevent denials.
• Create effective reporting tools to provide ongoing monitoring of denials and track resolution progress.
• Partner with revenue cycle management and finance teams to optimize cash collections and reduce denials.
• Present analysis and findings to leadership teams and offer recommendations for process improvements.
• Stay up to date with industry best practices related to denials management and compliance.

Qualifications and Requirements:

• Bachelor’s degree
• Proven experience in denials management, revenue cycle, or healthcare finance.
• Strong analytical skills with the ability to identify trends and draw actionable insights.
• Excellent communication and collaboration skills for partnering with cross-functional teams and clients.
• Proficiency in reporting tools and software (e.g., Excel, SQL, or other reporting platforms).
• Knowledge of healthcare billing and coding practices and regulations.
• Ability to multitask and manage time effectively in a fast-paced environment.

Preferred Skills:

• Experience in healthcare claims or revenue cycle management.
• Familiarity with denial codes, payer policies, and billing systems.
• Problem-solving skills and a proactive approach to identifying and mitigating risks.
• Experience using Epic

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.