DENIAL COORDINATOR (13701)

CULLMAN REGIONAL•Cullman, AL

3d•Onsite

About The Position

Analyzes claim denials and executes follow up to recover payment. Assists with provider credentialing and payor enrollment to maintain provider status and research denials. Coordinates with multiple departments as needed to determine the root causes of denials. Maintains a tracking log to monitor post-payment review findings and appeals. Identifies patterns in payor denials and reports recurring issues to management. Assists with claim submission, follow-up, and reporting needs throughout the clinically driven revenue cycle. Submits payer reconsiderations and appeals as necessary and completes follow-up for final resolution. Assists in the clinical revenue cycle to achieve the maximum appropriate reimbursement. Retrieves paper and electronic claims and remittance advice reports where necessary to overcome denials. Enters accurate and thorough documentation of pertinent events regarding the handling of the denial. Meets established production standards. Works in a collaborative fashion with the office, billing, and coding staff to improve overall processes.

Requirements

High school diploma required
Minimum three (3) years working in Medical Billing
Must be self-directed / self-motivated
Must have good communication and interpersonal skills
Must be able to perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure
Must be able to work independently
Must be able to recognize the rights and responsibilities of patient confidentiality
Must be able to relate to others in a manner which creates a sense of teamwork and cooperation
Must be able to maintain a customer focus and strive to satisfy the customer's perceived need

Nice To Haves

Some college coursework in a healthcare, business, or related field preferred

Responsibilities

Analyzes claim denials and executes follow up to recover payment
Assists with provider credentialing and payor enrollment to maintain provider status and research denials
Coordinates with multiple departments as needed to determine the root causes of denials
Maintains a tracking log to monitor post-payment review findings and appeals
Identifies patterns in payor denials and reports recurring issues to management
Assists with claim submission, follow-up, and reporting needs throughout the clinically driven revenue cycle
Submits payer reconsiderations and appeals as necessary and completes follow-up for final resolution
Assists in the clinical revenue cycle to achieve the maximum appropriate reimbursement
Retrieves paper and electronic claims and remittance advice reports where necessary to overcome denials
Enters accurate and thorough documentation of pertinent events regarding the handling of the denial
Meets established production standards
Works in a collaborative fashion with the office, billing, and coding staff to improve overall processes