Denial Mgmt Coordinator

FirstHealth of the Carolinas, Inc. • Pinehurst, NC

6d

About The Position

The Denial Management Coordinator is responsible for verifying insurance precertification requirements by accessing payer websites or contacting insurance providers directly. This verification is conducted in alignment with hospital contracts, payer guidelines, and applicable CPT codes for both scheduled and unscheduled services. The Coordinator ensures that all necessary actions are completed within established timeframes. Additional responsibilities may include initiating authorization requests and verifying patient benefits. This role may also require the Coordinator to float across various departments or locations as needed, demonstrating adaptability in support of staffing needs or fluctuations in patient volume. Floating assignments may encompass outpatient diagnostic imaging, surgical procedures, sleep studies, and the management of related denials. As time allows, the Coordinator may contribute to team development by training new or existing staff and offering support in other operational areas based on departmental workload demands.

Requirements

• Completion of High School or the equivalent
• Knowledge of medical terminology required
• Basic knowledge of computers required
• Previous healthcare or medical office experience required
• Strong communication and customer service skills required.
• Ability to work independently.
• Able to perform several simultaneous tasks in an organized manner.
• Ability to process information quickly and accurately while in a stressful environment.
• Must be able to type 35 to 40 wpm.

Responsibilities

• Verify precertifications obtained from internal and external providers
• Initiate authorizations
• Verify benefits for service being provided
• Float across various departments or locations as needed, demonstrating adaptability in support of staffing needs or fluctuations in patient volume.

What This Job Offers

• Career Level: Mid Level
• Education Level: High school or GED