CPC Denials Escalation Analyst
@ Allied Digestive HealthAllied Digestive Healthallieddigestivehealth.com
CPC Denials Escalation Analyst
West Long Branch, NJ
Posted 4 days ago
About the job
The company specializes in healthcare revenue cycle management, focusing on claims processing, denials management, and compliance audits to optimize payment and reduce denials.
Requirements
- 5+ years RCM experience
- Knowledge of CPT, HCPCS
- Experience with Athena, Epic
- Strong analytical skills
- Leadership in initiatives
Qualifications
- CPC, CPB, or AHIMA degree
- Detail-oriented and organized
- Excellent communication skills
- Ability to manage multiple tasks
- Ability to work independently
Full job description
CPC Denials Escalation Analyst
We are hiring for a CPC Denials Escalation Analyst at our Central Business Office in West Long Branch, NJ
Summary:
This position requires strong expertise in coding guidelines, payer policy, denials management, and claims processing. The CPC Denials Escalation Analyst will serve as a subject-matter expert on denied-claim escalations, contribute to denial-prevention strategies, perform chart reviews, and ensure claims are properly adjudicated for payment. The role supports complex A/R projects, denial coding reviews, and compliance audits while maintaining productivity and quality standards aligned with regulatory and organizational requirements.
Essential Responsibilities:
The responsibilities of the CPC Denials Escalation Analyst will include:
• Master claim denials and claims processing to support denial prevention strategies and drive claim resolution to payment.
• Review coding-related denials for potential correction and resubmission.
• Work assigned high-level A/R projects and complex claim investigations.
• Maintain adherence to quality and productivity standards established by the organization and industry guidelines.
• Follow up on escalated or project-related claims, working no fewer than 65-70 claims per day.
• Identify denial and payer trends and communicate findings to AR management.
• Conduct follow-up with Medicare and Commercial insurance payers on escalated claims.
• Assist in identifying the need for payer policy updates or process changes to support regulatory compliance and claim payment.
• Participates in special projects as assigned.
• Any other duties as assigned.
Education and Experience Required:
CPC, CPB, or AHIMA associate's degree
• 5+ years Revenue Cycle Management experience
• Strong understanding of CPT, HCPCS, accounts receivable, and charge capture workflows
• Experience with Athena, Epic, or comparable PM/EHR systems
We offer competitive base salary, generous benefits, including Medical, Dental, Vision, Life Insurance, Voluntary, Time-Off Benefits, EAP, 401K and Commuter Benefits.
Monday-Friday 8:30am-5:00pm
We are hiring for a CPC Denials Escalation Analyst at our Central Business Office in West Long Branch, NJ
Summary:
This position requires strong expertise in coding guidelines, payer policy, denials management, and claims processing. The CPC Denials Escalation Analyst will serve as a subject-matter expert on denied-claim escalations, contribute to denial-prevention strategies, perform chart reviews, and ensure claims are properly adjudicated for payment. The role supports complex A/R projects, denial coding reviews, and compliance audits while maintaining productivity and quality standards aligned with regulatory and organizational requirements.
Essential Responsibilities:
The responsibilities of the CPC Denials Escalation Analyst will include:
• Master claim denials and claims processing to support denial prevention strategies and drive claim resolution to payment.
• Review coding-related denials for potential correction and resubmission.
• Work assigned high-level A/R projects and complex claim investigations.
• Maintain adherence to quality and productivity standards established by the organization and industry guidelines.
• Follow up on escalated or project-related claims, working no fewer than 65-70 claims per day.
• Identify denial and payer trends and communicate findings to AR management.
• Conduct follow-up with Medicare and Commercial insurance payers on escalated claims.
• Assist in identifying the need for payer policy updates or process changes to support regulatory compliance and claim payment.
• Participates in special projects as assigned.
• Any other duties as assigned.
Education and Experience Required:
CPC, CPB, or AHIMA associate's degree
• 5+ years Revenue Cycle Management experience
• Strong understanding of CPT, HCPCS, accounts receivable, and charge capture workflows
• Experience with Athena, Epic, or comparable PM/EHR systems
We offer competitive base salary, generous benefits, including Medical, Dental, Vision, Life Insurance, Voluntary, Time-Off Benefits, EAP, 401K and Commuter Benefits.
Monday-Friday 8:30am-5:00pm
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