Professional Denials Coordinator

Oklahoma Heart Hospital • Oklahoma City, OK

3h • Onsite

About The Position

The Professional Denials Coordinator works on targeted insurance denials to improve collections and reduce open balances. The role handles inpatient notices of admission, authorizations, and subsequent denials, and assists with first- and second-level appeals under the guidance of a Denials Manager and Denials RN. The coordinator helps identify denial trends and root causes, sharing high-impact findings with the Denials Manager to help prevent future denials.

The coordinator defends and appeals claims by researching root causes, gathering required information, adjusting accounts as necessary, resubmitting claims, and completing appropriate follow-up. The role also submits requests to clarify clinical documentation for accurate coding of denials and works with the Denials Analyst and Underpayments Coordinator to identify opportunities and system or process errors.

Requirements

• At least two years of experience in professional or clinic insurance follow-up or denials.
• Working knowledge of insurance collections and denials, with an emphasis on professional coding, is preferred.

Nice To Haves

• High school graduate or equivalent.
• Clinical denials experience.
• Epic experience.
• CPC certification is strongly encouraged.

Responsibilities

• Work on targeted insurance denials to improve collections and reduce open balances.
• Handle inpatient notices of admission, authorizations, and subsequent denials.
• Assist with first- and second-level appeals under the guidance of a Denials Manager and Denials RN.
• Identify denial trends and root causes and provide high-impact findings to the Denials Manager to help prevent future denials.
• Research root causes, collect required information, adjust accounts as necessary, resubmit claims, and complete appropriate follow-up activities when defending and appealing claims.
• Submit requests to clarify clinical documentation for accurate coding of denials.
• Work with the Denials Analyst and Underpayments Coordinator to identify areas of opportunity and system or process errors.

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. Benefits may vary by position, and some roles may have exclusions; for eligible positions, benefits start on the first day.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED