Clinical Denials Assistant

Franciscan AllianceIndianapolis, IN
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
  • organized candidate with insurance experience
  • denial process knowledge
  • strong willingness to learn

Responsibilities

  • Collaborate with Authorization Denials Team reviewing cardiac testing denials, filing appeals, scheduling Peer to Peers, keeping patient informed of process, and following up with insurance companies
  • 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, and 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
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