Coordinator, Denials Management

CorroHealth•NJ-Remote, NJ

2d•Remote

About The Position

CorroHealth partners with healthcare providers to address revenue cycle challenges through services, consulting, and technology. The Coordinator, Denials Management reviews and works assigned accounts, distinguishing clinical from technical denials and pursuing appropriate resolution through payer contact and appeals. The position is remote within the United States and follows a Monday–Friday schedule from 8:00 AM to 4:30 PM EST. The ideal candidate has at least two years of experience distinguishing clinical and technical denials using EOBs, denial letters, payer correspondence, and data mining; is familiar with UB04 and/or HCFA 1500 forms; and is comfortable contacting payers to negotiate denial resolutions. A high school diploma or equivalent is required, and a four-year degree is preferred.

Requirements

High school diploma or equivalent.
At least two years of experience in a hospital-related billing or follow-up field.
Knowledge of or experience working with managed care contracts.
Experience with customer support or client issue resolution management.
Strong analytical acumen.
Proficiency with Microsoft Office.
Experience distinguishing clinical and technical denials using EOBs, denial letters, payer correspondence, and data mining.
Knowledge of UB04 and/or HCFA 1500 forms.
Comfort contacting payers to negotiate denial resolutions.

Nice To Haves

Four-year degree.

Responsibilities

Differentiate clinical and technical denials using EOBs, denial letters, payer correspondence, and data mining.
Review UB04 and/or HCFA 1500 forms.
Review timely filing guidelines for the appeals process.
Contact payers to negotiate resolution of technical denials.
Appeal denials using appeal letters, medical records, supporting documentation, and on-staff clinicians as needed.
Evaluate appeal outcomes to determine next steps, including logging recovered funds, supporting an upheld decision, or initiating a second-level appeal.
Manage assigned accounts through timely follow-up and accurate recordkeeping.