Denials Analyst Fulltime Days

Description

Baylor Scott & White Medical Center - Sunnyvale is an acute care hospital serving the communities in and around Sunnyvale, Texas. We strive to make the lives of our patients and their families better at every interaction. Our Team Members live out this passion in their daily roles as we support their career and personal goals.

We are located just minutes east of Dallas and south of Garland / Rowlett on Hwy 80 at Collins Road in Sunnyvale. Many team members live in Forney, Mesquite, Garland, Balch Springs, and Rockwall areas with a short commute.

Our work environment includes:

• Modern Office Setting
• On-Site Cafe' and Coffee Bar (Payroll Deduction available)
• Collaborative Teams
• Team Member engagement opportunities
• Competitive pay
• Benefits provided based on your work assignment (Full-time, Part-time, or PRN)

Baylor Scott & White Medical Center - Sunnyvale is seeking a Denials Analyst to performs the daily functions of denial resolution which primarily includes researching accounts, analyzing EOBs, and interacting with insurance companies for resolution of denied balances.

What your day will look like:

• Must be a hands-on problem solver and effective communicator to support the goals of the Hospital Business Office.
• Responsible for identifying the root cause of low or non-payments to achieve increased cash and a reduction in payer denials and overall bad debt accounts.
• Provide patient data to payers for resolution of denials due to medical necessity.
• Assist in identifying potential errors created as a result of incorrect claims processing, wrong eligibility records, late or missing provider submissions, and address payers’ questions to improve Hospital’s overall billing and reimbursement.
• Perform research in Cerner and review EOBs for accounts identified as denied, underpayment, or “No-Status Available”
• Communicate with patients for coordination of benefits as needed to get claims processed
• Communicate with payers for re-submission of patient account data and coordinate with CSO as needed
• Communicate with patients, physician staff, and insurance companies
• Perform root cause analysis on denials and work with appropriate staff to eliminate core problems causing denials.

Success Factors:

• Associates or Bachelor's Degree preferred but not required
• Minimum 3-5 years of experience in working Denied A/R and underpaid medical accounts
• Solid understanding of Revenue Cycle functions and Business Office operations strongly preferred
• Ability to communicate in English; both verbally and in writing.
• Additional languages preferred.
• Competent utilizing Microsoft Office Excel and Word.
• Experience with Cerner software
• Strong leadership, communication and organizational skills required