Clinical Denials Assistant

Franciscan Alliance, Inc. • Indiana Heart Physicians Building, IN

7d • Onsite

About The Position

At Franciscan, our Clinical Denials Assistant is an important when working with the Authorization Denials Team by reviewing cardiac testing denials, filing appeals, scheduling Peer to Peers, keeping patient informed of process, and following up with insurance companies. In this role you will also serve as a liaison to the cardiac providers by providing direct coordination with insurance providers for appeals and providing education and updates on insurance changes to reduce denials.

Requirements

• High School Diploma/GED
• 1 year Computer Experience
• 1 year Medical Terminology
• 1 year Insurance Claim Knowledge

Nice To Haves

• Associate's Degree

Responsibilities

• Reviewing cardiac testing denials
• Filing appeals
• Scheduling Peer to Peers
• Keeping patient informed of process
• Following up with insurance companies
• Serve as a liaison to the cardiac providers
• Providing direct coordination with insurance providers for appeals
• Providing education and updates on insurance changes to reduce denials
• Initiate education to providers of insurance changes and unique coding needs to reduce denials
• Facilitate direct connection for peer-to-peer insurance provider to on-site provider, reducing lag time for providers
• Initiate pulling updated compliance with insurances on a regular basis ensuring the most recent requirements for testing are secured
• Provide updates to leaders and physicians
• Inform patients of insurance denials and next steps
• Liaison between satellite locations and authorization team for processes and updates
• Conduct RVU audits and tracks claim denials
• Review volume and denial reasonings with leadership, making recommendations based on patterns

Benefits

• Comprehensive benefit offerings

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED