Coordinator, Denials Management

CorroHealth

2d•Remote

About The Position

CorroHealth is the partner of choice to healthcare providers in support of their Revenue Cycle challenges. We solve problems through a customized mix of services, consulting and technology that can change over time to meet any client’s evolving needs. We work with 300+ providers in 25+ states and bring a client-focused approach that makes each provider feel like our only client. CorroHealth offers the following products and services: Denials Management and Complex Claim Resolution, A/R Outsourcing, Patient Access, Revenue Cycle Technology, and Consulting.

Requirements

At least 2 years' experience differentiating between clinical and technical denials through EOB’S, denial letters/payer correspondence and data mining.
Knowledgeable and have worked with UB04 and/or HCFA 1500 Forms.
Comfortable contacting payers to negotiate resolution on denials.
Strong analytical acumen.
Strong multi-tasking skills.
Proficiency with MS Office.
Excellent oral and written communication skills.

Nice To Haves

Four-year degree preferred or equivalent experience in hospital related billing/follow-up field.
Benefits/fund administration experience preferred.
Knowledge of/experience working with managed care contracts.
Experience working with customer support/client issue resolution management.

Responsibilities

Differentiates between clinical and technical denials through EOB'S, denial letters/payer correspondence and data mining.
Identifies payer and hospital’s managed care contracts.
Reviews managed care contracts against application of rates, provisions and terms.
Reviews timely filing guidelines regarding the appeals process.
Contacts payers to negotiate resolution on technical denials.
Appeals denials using all means necessary (appeal letters, medical records and other supporting documentation, utilization of on-staff clinicians).
Evaluates appeal outcome for next steps (logs recovered funds, supports uphold decision or initiates 2nd level appeal).
Manages assigned workload of accounts through timely follow up and accurate record keeping.