Hospital Denials Coordinator

Oklahoma Heart Hospital•Oklahoma City, OK

About The Position

ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients’ journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we’re shaping the future of heart care in Oklahoma by serving the state and leading the nation. Why You'll Love Working Here: Comprehensive Benefits: Medical, Dental, and Vision coverage 401(k) plan with employer match Long-term and short-term disability Employee Assistance Programs (EAP) Paid Time Off (PTO) Extended Medical Benefits (EMB) Opportunities for continuing education and professional growth Please note that benefits may vary by position, and some roles (like PRN, Flex, Float, etc.) may have exclusions. For eligible positions, benefits start on your first day! We can’t wait for you to join our heart-centered team! The Hospital Denials Coordinator will work on targeted insurance denials to improve collections and reduce open balances. They will deal with inpatient notices of admission, authorizations, and subsequent denials. The Hospital Denials Coordinator will assist with first and second level appeals under the Denials and Appeals RN’s guidance. The Denials Coordinator will assist in identifying trends and finding root causes to prevent future denials, providing high-impact findings to the Denials Manager. Every team member at OHH plays an integral role in our patients’ experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care. Learn more about diversity at Oklahoma Heart Hospital. As part of our team, you are empowered to work collaboratively with our physicians and other caregivers, and play an integral role in setting the standard for excellence in patient care. Every team member at OHH plays an integral role in our patients’ experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care.

Requirements

Education: High school graduate or equivalent preferred.
Experience: Minimum of two (2) years in technical Insurance Follow-Up or Denials.
Working Knowledge: Insurance collections and denials, with an emphasis on inpatient workflows is preferred.
Essential Cognitive Abilities: Requires strong communication and organizational skills. Must demonstrate independent judgment and sound reasoning ability. Ability to maintain concentration and organization while dealing with multiple issues and frequent interruptions.

Nice To Haves

Clinical Denials experience is preferred
Epic experience is a plus but not required.

Responsibilities

Works under the guidance of a Denials Manager and Denials and Appeals RN to prepare appeals on clinical denials.
Submits Notices of Admission for any missing inpatient admission to insurance companies.
Defend and appeal claims, including researching root cause, collecting required information, adjusting the account as necessary, resubmitting claims and all appropriate follow up activities.
Requests inpatient authorizations on any admissions that did not receive authorization while the patient was in-house.
Works with Denials Analyst and Underpayments Coordinator to call attention to areas of opportunity or system/process errors.