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Denials Management Prevention Analyst
- AdventHealth (Maitland, FL)
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Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that **together** we are even better.
All the benefits and perks you need for you and your family:
+ Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
+ Paid Time Off from Day One
+ 403-B Retirement Plan
+ 4 Weeks 100% Paid Parental Leave
+ Career Development
+ Whole Person Well-being Resources
+ Mental Health Resources and Support
+ Pet Benefits
Schedule:
Full time
Shift:
Day (United States of America)
Address:
2600 LUCIEN WAY
City:
MAITLAND
State:
Florida
Postal Code:
32751
Job Description:
Collects, analyzes, and reports data for insights into denials management operations and special prevention projects. Communicates and presents insights and recommendations to the denials management committee on prevention activities. Coordinates material and provides updates for key denials prevention program documentation. Reviews managed care contracts and compares them against patient claims to identify and prevent claim underpayments. Provides feedback to managed care on identified underpayment issues for remediation with the payor. Tracks payer audit requests and monitors adherence to contractual terms, communicating violations to the managed care contract team. Leads denials management prevention projects by gathering and analyzing data to support process improvement. Develops and maintains up-to-date denials management staff job aides, training materials, and playbooks. Onboards and continuously trains denials management staff on workflow, technology, policies, and procedures. Travels to individual facilities or business offices as needed to conduct trainings, provide operational support, and attend meetings. Communicates and coordinates with various individuals and departments to assist with monitoring claims prevention activities. Strives to meet and exceed productivity and quality expectations, escalating concerns or difficulties in a timely manner for management action. Performs other duties as assigned.
The expertise and experiences you’ll need to succeed:
QUALIFICATION REQUIREMENTS:
High School Grad or Equiv (Required)
Pay Range:
$49,718.59 - $92,468.74
_This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances._
**Category:** Patient Financial Services
**Organization:** AdventHealth Corporate
**Schedule:** Full time
**Shift:** Day
**Req ID:** 150698281
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