Revenue Integrity Analyst

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. CPC Denials Escalation Analyst Full Time West Long Branch, NJ, US 4 days ago Requisition ID: 3608 Salary Range: $27.00 To $31.00 Hourly 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. 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. The CPC Denials Escalation Analyst must be extremely detail‑oriented. The CPC Denials Escalation Analyst must be able to comprehend all issues and articulate them to any person involved(s) needed to assist in their complete resolution. He/she must also possess: Qualifications Advanced analytical and reporting skills Basic understanding of rudimentary medical terminology Excellent judgment and decision‑making Problem‑solving and organizational skills Reliability, Accuracy, and Efficiency when dealing with patients or third‑party payors Excellent verbal and written communication skills Ability to use good judgment in highly emotional and demanding situations Ability to react to frequent changes in duties and volume of work Excellent oral and written communication skills Ability to manage multiple tasks with ease and efficiency Ability to work independently with minimal supervision and be result‑oriented Effective interpersonal skills, including the ability to promote teamwork Strong problem‑solving skills Ability to ensure a high level of customer satisfaction, including employees, patients, physicians, and external stakeholders Maintains confidentiality of sensitive information Broad knowledge of health care business office practices and principles 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 #J-18808-Ljbffr