Denials Coordinator

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Description:

Job Summary

Responsible for coordinating the denial and appeal process in conjunction with care management staff and the Business Office, meeting goals and timelines for appeals, and tracking outcomes.

Qualifications

• Associate's Degree in Business Administration or a closely related field or High School Diploma or GED and 4 years of additional experience in the Revenue Cycle with experience with analytics and denials. Required
• Bachelor's Degree in Business Administration or a closely related field Preferred

Work Experience

• => 1 year in healthcare data analytics and/or application support Required
• => 7 years of experience in the Revenue Cycle experience with a concentration in Patient Accounting, to include billing, follow-up, denials, and denial recovery Required

Licenses, Certifications and Required Training

• CPAS- Certified Patient Account Specialist or CPAR Certification must be obtained within 20 months of hire. within 1-1/2 Yrs Required

EDUCATION REQUIREMENTS

• 2-year / Associate Degree in Business Administration or a closely related field. In lieu of an Associate's Degree, a High School Diploma, and a minimum of 8 years of experience in the Revenue Cycle with experience with analytics and denials. (Required)

EXPERIENCE REQUIREMENTS

• 2 - 3 years in a Health Care data analytics and/or application support (Required)
• 8+ years of experience in the Revenue Cycle experience with a concentration in Patient Accounting to include billing, follow-up, denials, and denial recovery. (Required)

CERTIFICATIONS AND LICENSURES

Required Certifications/Licensures: CPAR Certification must be obtained within 20 months of hire.

Job Knowledge

Possesses current and comprehensive skills and knowledge to perform all parts of the job effectively and efficiently. Exhibits ability to learn and apply new skills, professional knowledge, and expertise as well as guide the team in learning new and applying new skills. Requires minimal day-to-day direction to perform responsibilities. Acts as a resource in the area of specialty and are able to share best practices and answer questions as needed.

GENERAL SKILLS

• Organizational Skills
• Communication Skills
• Interpersonal Skills
• Customer Relations
• Mathematical
• Analytical
• Grammar / Spelling
• Read / Comprehend Written Instructions
• Follow Verbal Instructions
• Transcription
• Mechanical
• Basic Computer Skills
• Microsoft Office Suite
• General Clerical Skills

PHYSICAL REQUIREMENTS

• Have near normal vision - Clarity of vision (both near and far), ability to distinguish colors
• Have good - manual dexterity and eye-hand-foot coordination
• Ability to perform - repetitive tasks/motion

PHYSICAL DEMANDS

• Standing - Occasionally within shift (1-33%)
• Walking - Occasionally within shift (1-33%)
• Sitting - Continuously within shift (67-100%)
• Climbing - Occasionally within shift (1-33%)
• Bending/Stooping - Occasionally within shift (1-33%)
• Twist at waist - Frequently within shift (34-66%)
• Pushing/Pulling - Occasionally within shift (1-33%)
• Lift/carry up to 20 lbs - Occasionally within shift (1-33%)
• Lift/carry > 20 lbs with assistance - Occasionally within shift (1-33%)
• Reaching above shoulder - Occasionally within shift (1-33%)