HIS Denials Specialist (INPATIENT)
About The Position
Summary of Position:#Under general supervision of the Manager, Health Information Services, the Denials Specialist performs activities to ensure appropriate financial reimbursement for HIS inpatient services from payers.# This position provides a vital link between inpatient coding, clinical documentation improvement, Patient Access (PA) and Patient Financial Services (PFS). The Denials Specialist is responsible for tracking denied HIS inpatient accounts, working with HIS Coders, payers, Department Directors, Clinical Managers, Case Management, Patient Access, and PFS.# Actively contributes to the morale and teamwork of the staff and facility always presenting a positive attitude and patient minded vision with patient satisfaction as the continuing goal.
Requirements
- RHIT, RHIA, CCS, CPC, etc and 3 years of experience with coding, abstracting, or billing experience. (or other equivalent credential and experience.)
- Associate#s Degree Required, Bachelor Degree preferred.
Responsibilities
- Uses software such as AUDAPRO, TRISUS, 3M, and Meditech.
- Conducts trend analysis to identify patterns and variances in denied accounts
- Researches denied accounts to determine appropriate appeal/response to the denial notification to resolve claim.
- Tracks denied and overturned accounts, compiling routine and ad hoc reports.
- Develops and coordinates educational and training programs regarding trends in coding denials
- Initiates corrective action to ensure resolution of problem areas identified during internal or external auditing and provides feedback and focused educational programs on the results of auditing and monitoring activities to affected staff and physicians.
- Demonstrates competency in the use of computer applications and all coding convention and abstracting software and hardware currently in use by the Health Information Services Department.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Hospitals
Education Level
Associate degree
