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Clinical Information Review Analyst – Behavioral Health
Banner HealthClinical Information Review Analyst specializing in billing and documentation for Behavioral Health unit at Banner Thunderbird Medical Center. Engaging with insurance payors and resolving financial discrepancies ensuring healthcare service utilization.
About the role
Key responsibilities & impact- Evaluate patient records to address level-of-care coverage issues, payor outliers, and denied claims
- Analyze clinical charts to identify gaps in physician and provider documentation
- Collaborate with Patient Financial Services, insurance payors, and billing staff to resolve payment discrepancies
- Track denial trends, educate billing staff, and serve as an internal compliance and regulatory resource
- Work independently under limited supervision and make independent judgments based on specialized knowledge
Requirements
What you’ll need- BS in Nursing or Equivalent
- Experience in the Behavioral Health setting or Utilization Review
- Five or more years of clinical nursing or related experience
- Master's level Social Work in healthcare, behavioral health counseling, or related experience is also acceptable
- Working knowledge of utilization management and patient services
- Working knowledge of Medical and third party payor requirements and reimbursement methodologies
- Arizona Fingerprint Clearance Card at the time of hire (if applicable)
- Organizational, written and verbal communication skills
Benefits
Comp & perks- Health insurance
- 401(k) matching
- Flexible working hours
- Paid time off
- Professional development opportunities
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
utilization managementpatient servicesclinical nursingbehavioral healthdocumentation analysisclaims resolutionpayor requirementsreimbursement methodologiesdenial trend trackingcompliance knowledge
Soft Skills
organizational skillswritten communicationverbal communicationindependent judgmentcollaboration
Certifications
BS in NursingArizona Fingerprint Clearance Card