Denials Management Operations Analyst

Reposted 13 Days Ago
Be an Early Applicant
Belfast, ME, USA
In-Office
30K-52K Annually
Junior
Healthtech • Information Technology • Telehealth
Curing complexity to simplify the practice of care.
The Role
The Denials Management Operations Analyst analyzes and resolves claims for revenue cycle success, identifies trends, and improves processes. Responsibilities include managing work queues, critical thinking, and training others.
Summary Generated by Built In

Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Position Summary:

The Denials Management Operations Analyst is responsible for analyzing a queue of work related to revenue cycle success. This includes working claims escalated from our business partners and/or other health insurance claim-based work excluded from our standard workflows. Following established workflows and identified best practices, you will research and resolve claims to support the creation of a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.   Your responsibilities will include analysis and appropriate resolution of a queue of work within a contractually specified timeframe in the most efficient manner possible, identifying trends through observation and investigation, and escalating opportunities for improvement to the appropriate business unit. You are detail oriented, with a focus on work efficiency and quality. You possess a collaborative mindset and a desire to achieve subject matter expertise in your assigned area of work. You have critical thinking skills and are process improvement driven.  

About the Team:

The Rejection and Denial Analysis team empowers athenahealth to deliver industry-leading clean claim performance by identifying and investigating the drivers of rejections and denials, delivering and managing a robust, cross-functional feedback loop of data-driven opportunities that enable effective prevention and management.

Essential Job Responsibilities:

60% Queue Based Work 

  • Ensures accurate entry of information into athenaNet and trading partner applications.

  • Builds and maintains expert subject matter knowledge of assigned processes in order to be a resource for clients and internal stakeholders

  • Works with key stakeholders (internal and/or external) across geographies to perform tasks

  • Removes obstacles and works independently to ensure completion of assigned tasks within specified turnaround times and adhering to established goals

  • Prioritizes work effectively in a fast-paced environment

  • Demonstrates flexibility & adaptability when business directives change

  • Possesses a high level of attention to detail and holds self to equally high-quality standards

  • Embodies athenahealth’s values and behaviors

  • Leverages all available resources to solve problems

20% Trend Identification/Critical Thinking & Problem Solving

  • Identifies and surfaces workflow inconsistencies

  • Communicates opportunities for innovation and process refinement

  • Evaluates alternative methodologies when applicable and implements appropriate solutions to new problems

  • Presents information and concepts in a professional and organized manner

  • Leverages all available resources to solve problems

  • Identify error trends in your work and escalate where appropriate

  • Navigate the organization with professionalism

20% Training & Professional Development

  • Participates in training opportunities by leveraging appropriate growth

  • Shares useful information and guidance with teams

  • Accepts, delivers and implements both positive and constructive feedback

  • Demonstrates behaviors of our Values

  • Engages in dialogue to facilitate trust and understanding of others

  • Initiates opportunities to experience and learn new skills in support of personal career development

  • Provides training & mentoring to peers to ensure client needs are met and work is completed accurately

  • Becomes an engaged and active participant in athenahealth’s teaching and learning culture by demonstrating tenacity and teamwork

  • Demonstrates commitment to becoming a subject matter expert

Expected Education & Experience:

  • Bachelor’s degree preferred or 2-4 years of professional experience preferred

  • Effective communication and business writing skills

  • Microsoft Office Suite, basic computer skills including proficient typing and navigation

  • Effective communication and interpersonal relationship skills

  • Solid planning and organizational abilities

  • Time management skills and ability to prioritize work based on criticality

  • Critical thinking and problem-solving skills

  • Works independently as well as part of an extended, cross-functional team

  • Experience working with cross-functional groups and teams to achieve common goals

  • Flexibility and adaptability in approach to challenges to achieve desired outcomes

  • Displays initiative, tenacity and flexibility in a fast-paced team environment

  • Attention to detail


Expected Compensation

$30,000 - $52,000

The base salary range shown reflects the full range for this role from minimum to maximum. At athenahealth, base pay depends on multiple factors, including job-related experience, relevant knowledge and skills, how your qualifications compare to others in similar roles, and geographical market rates.  Base pay is only one part of our competitive Total Rewards package - depending on role eligibility, we offer both short and long-term incentives by way of an annual discretionary bonus plan, variable compensation plan, and equity plans.


About athenahealth

Our vision: In an industry that becomes more complex by the day, we stand for simplicity. We offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients — powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Our company culture: Our talented  employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our vision. We are a diverse group of dreamers and do-ers with unique knowledge, expertise, backgrounds, and perspectives. We unite as mission-driven problem-solvers with a deep desire to achieve our vision and make our time here count. Our award-winning culture is built around shared values of inclusiveness, accountability, and support.

Our DEI commitment: Our vision of accessible, high-quality, and sustainable healthcare for all requires addressing the inequities that stand in the way. That's one reason we prioritize diversity, equity, and inclusion in every aspect of our business, from attracting and sustaining a diverse workforce to maintaining an inclusive environment for athenistas, our partners, customers and the communities where we work and serve.

What we can do for you:

Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative  workspaces  — some offices even welcome dogs.

We also encourage a better work-life balance for athenistas with our flexibility. While we know in-office collaboration is critical to our vision, we recognize that not all work needs to be done within an office environment,full-time. With consistent communication and digital collaboration tools, athenahealthenablesemployees to find a balance that feels fulfilling and productive for each individual situation.

In addition to our traditional benefits and perks, we sponsor events throughout the year, including book clubs, external speakers, and hackathons. We provide athenistas with a company culture based on learning, the support of an engaged team, and an inclusive environment where all employees are valued. 

Learn more about our culture and benefits here: athenahealth.com/careers  

https://www.athenahealth.com/careers/equal-opportunity

Top Skills

Athenanet
Microsoft Office Suite
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The Company
HQ: Boston, MA
7,200 Employees
Year Founded: 1997

What We Do

athenahealth strives to cure complexity and simplify the practice of healthcare. Our innovative technology includes electronic health records, revenue cycle management, and patient engagement solutions that help healthcare providers, administrators, and practices eliminate friction for patients while getting paid efficiently. athenahealth partners with practices with purpose-built software backed by expertise to produce the insights needed to drive better clinical and financial outcomes. We’re inspired by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.  For more information, please visit www.athenahealth.com

Why Work With Us

We are here to make an impact on the healthcare industry at scale. We enable our diverse teams to move fast, grapple with interesting technical challenges, and innovate at every level. We are on a modernization journey and build on the hybrid cloud. We deliver best-in-class solutions to help every patient receive the best possible care.

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