Data Analyst, Appeals, Fulltime, Remote, NJ

The Center for Comprehensive Care

The Center for Comprehensive Care, part of RWJBarnabas Health, is looking for a Data Analyst to join their Appeals department. This role is essential in ensuring the accurate pursuit of appeals for clinical denials. The team is committed to leveraging data insights to support healthcare services and improve patient outcomes.

In this role you can expect to have the responsibilities:

• Validate clinical and technical denials
• Order medical records and enter denials
• Communicate with payers to gather account information
• Formulate and submit appeal for no authorization/medical necessity denials
• Analyze and research denials, and follow-up with payers
• Review applicable timeframes for appeals
• Contact third parties for clinical appeal outcomes
• Evaluate appeal outcomes for next steps
• Document follow-up requirements on denials
• Maximize use of Contract Management tools for cash collection

This role comes with the following benefits:

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits like Pet Insurance
• Discounts through Partners

This role requires you to have:

• Proficiency in medical terminology
• Knowledge of commercial insurance
• Average Microsoft Excel skills
• Experience in hospital/payer roles

You would benefit from having:

• Associate degree in business or finance

RWJBarnabas Health is committed to providing a high-quality work experience. They emphasize an inclusive environment, focusing on community health via innovative strategies and partnerships. They are an Equal Opportunity Employer.