Denial Coordinator

LSMA Management Inc • San Bernardino, CA

11d

About The Position

The Denial Coordinator serves as a key liaison between patients, providers, health plans, and internal clinical leadership regarding utilization management denial and carve-out notifications in accordance with regulatory, health plan, CMS, and organizational standards. The Denial Coordinator ensures compliance, confidentiality, and effective communication while supporting audits, resolving inquiries, and promoting patient-centered service.

Requirements

• High school diploma or equivalent.
• 2+ years of medical office or healthcare administrative experience.
• Typing certificate demonstrating a minimum of 45 WPM
• Knowledge of medical terminology and healthcare administrative processes.
• Working knowledge of CPT, HCPCS, and ICD-10 coding.
• Strong written and verbal communication skills.
• Ability to interpret benefit coverage and utilization management determinations.
• High attention to detail with strong proofreading and documentation accuracy.
• Ability to organize, prioritize, and manage multiple deadlines in a fast-paced environment.
• Proficiency with general computer applications and electronic health record systems.
• Ability to exercise sound judgment and make independent decisions within established guidelines.
• Demonstrated professionalism, dependability, and service-oriented mindset.
• Effective problem-solving and conflict-resolution skills.
• Ability to work collaboratively and maintain positive interdepartmental relationships.

Nice To Haves

• Coursework or training in healthcare administration, utilization management, or medical billing/coding.
• 1+ years of Utilization Management experience.
• Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.

What This Job Offers

• Education Level: High school or GED