Sr. Denials Management Analyst

Job Description

Job Description

Salary :

Join a Respected Birmingham Team. Drive Denial Resolution. Make a Local Impact.

Westerkamp Group, LLC is a Birmingham-based Revenue Cycle Management (RCM) company helping hospitals across Alabama and the Southeast improve cash flow, reduce denials, and ensure accurate reimbursement. We are a trusted name in healthcare administration, built on a legacy of precision, transparency, and partnership.

Were currently hiring a Senior Denials Management Analyst to support a fast-growing hospital billing project. This on-site role is based at our Birmingham office at 200 Century Park South , with free parking and flexible scheduling options to help you commute outside of peak traffic times. Its an opportunity to make a meaningful difference in hospital financial health and to grow your career in a stable and respected local organization .

Key Responsibilities

• Coordinate the Denial Management activities for Hospital Based denials from various government and third-party payers.
• Provide reporting support for standard monthly denial reporting and ad-hoc denial report requests.
• Develop a monthly Denial Management MOR report and present it in person to senior management (company and client) during the monthly client meeting.
• Analyze specific payer denials and recommend resolution.
• Communicate with the insurance follow-up team and the appeals team to recommend actions for specific denials.
• Contact insurance payers when appropriate to identify the true nature of the denials
• Identify underpayments on large balance claims and validate the correct reimbursement model that was used for payment.
• A broad understanding of complex revenue cycle management concepts and theories including reimbursement models (MS-DRG, APR-DRG, EAPGs, carveouts, fee schedule hierarchies), CMS Local Coverage Determinations and National Coverage Determinations, Medical Policies, General Medical Coding concepts, extensive understanding of UB-04 claim concepts, among others.
• Escalate complex denial issues to senior management with recommendations for further actions to resolve claim denial issues.
• Coordinate configuration updates in Epic related to denial classification and source / owning departments.
• Monitor payer denials for trends and new denial issues caused by changes in their authorization / pre- cert / notification / referral requirements.

Qualifications

What We Offer

Our Recruitment Process

Qualified candidates will receive anemail invitation to complete a brief video interview. We value your time and aim to make the process smooth and flexible based on your availability. If you are unable to complete the video interview, please contact us to requestalternative interview options.

Equal Opportunity & Accommodations

Westerkamp Group, LLC, is anEqual Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, gender, national origin, disability, age, veteran status, or any other legally protected status.

If you need areasonable accommodationduring any stage of the application or interview process, please contactdbourgeois@wgrcm.com or call 985-655-0300.