Denials Analyst

Job Description

Westerkamp Group, LLC is an Accounts Receivable Management company focused on hospital and professional billing and collections. We are currently seeking a Denial Analyst. This operational role is ideal for an individual who thrives in a leadership role, possesses exceptional analytical skills, and has a deep understanding of Epic configurations and their impact on the denial lifecycle.

Job Description:

We are seeking a highly motivated and experienced Denial Analyst with a strong background as an Epic Analyst. In this crucial role, you will lead a team of denial specialists, driving the resolution of denied claims, identifying root causes, and implementing strategies to prevent future denials. Your dual expertise in denial management and Epic PB functionality will be critical in optimizing workflows, providing actionable insights, and ensuring maximum revenue capture for our clients.

Key Responsibilities:

- Identify, analyze, and trend common denial reasons (e.g., medical necessity, lack of authorization, coding errors, timely filing, incorrect modifiers).

- Develop and implement strategies to overturn denials and accelerate payment resolution.

- Act as a subject matter expert for Epic Resolute, specifically as it relates to denial prevention and resolution.

- Analyze Epic workflows and configurations to identify root causes of denials stemming from system setup or user error.

- Assist in troubleshooting Epic related issues that lead to denials.

- Develop and maintain denial management policies and procedures.

- Prepare and present regular reports on denial trends, recovery rates, and team performance to RCM leadership and clients.

Required Qualifications:

- 1+ years of direct, hands-on experience as an Epic Professional Billing (PB) Analyst or in a role heavily utilizing Epic PB for operational analysis and workflow optimization.

- Epic Resolute Certification is highly preferred. Additional Epic certifications (e.g., Prelude, Cadence) are a plus.

- Strong understanding of professional medical coding (CPT, ICD-10, HCPCS), claim submission (CMS-1500), and remittance processing (ERA/EOB).

- Exceptional analytical, problem-solving, and critical thinking skills.

- Excellent leadership, communication (verbal and written), and interpersonal skills.

-Proficient in Microsoft Excel (for data analysis and reporting).

Equal Opportunity & Accommodations

Westerkamp Group, LLC, is an Equal 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 a reasonable accommodation during any stage of the application or interview process, please contact dbourgeois@wgrcm.com or call 985-655-0300.