Denials Prevention Analyst, CPC or COC Certified

Thanks for your interest in Children's Mercy! Do you envision finding a meaningful role with an inclusive and compassionate team? At Children’s Mercy, we believe in making a difference in the lives of all children and shining a light of hope to the patients and families we serve. Our employees make the difference, which is why we have been recognized by U.S. News & World Report as a top pediatric hospital, for eleven consecutive years.

Children’s Mercy is in the heart of Kansas City – a metro abounding in cultural experiences, vibrant communities and thriving businesses. This is where our patients and families live, work and play. This is a community that has embraced our hospital and we strive to say thanks by giving back. As a leader in children’s health, we engage in meaningful programs and partnerships throughout the region so that we can improve the lives of children beyond the walls of our hospital.

The Denials Prevention Analyst is directly responsible for reviewing current denial data to determine denial trends and provide root cause analysis utilizing available CMH technology as well as expert colleagues and specific payor representation/information. This position will collaborate with internal stakeholders to review denial trends and assist in identifying and tracking implementation of root cause resolutions under the supervision of the Denials Prevention leadership within CMH.

This position also adheres to the Shared Values and Service Excellence visions of the organization.

Must have a Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) at time of application.

This is a mostly remote role, but incumbent must reside within the KC Metro and may come onsite for meetings and training as required.

Epic Experience Highly Preferred!

At Children’s Mercy, we are committed to ensuring that everyone feels welcomed within our walls. A successful candidate for this position will join us as we strive to create a workplace that reflects the community we serve, as well as our core values of kindness, curiosity, inclusion, team and integrity.

Additionally, it’s important to us that we remain transparent with all potential job candidates. Because we value the safety of the patients and families we serve, as well as the Children’s Mercy staff, we want to let you know that the seasonal influenza vaccine is a condition of employment for all employees in our organization. New employees must be willing to be vaccinated if found non-immune to measles, mumps, rubella (MMR) and chicken pox (varicella) and/or without evidence of tetanus, diphtheria, acellular pertussis (Tdap) vaccination since 2005.

If you are selected for this position, you will be asked to supply your immunization records as proof of vaccination. If you and have any concerns about receiving these vaccines, medical and/or religious exemptions can be further discussed with Human Resources.

• Analyze and research claim denial trends utilizing denial reporting tools to identify root cause issues and collaborates with the Denials Prevention team leadership to identify potential resolution and offer potential process improvements.
• Performs all necessary duties related to the identification and tracking of denial trends/issues and monitors cross-departmental performance improvements to insure denial resolution and/or mitigation.
• Adheres to service excellence guidelines and CMH policies and procedures and demonstrates exceptional customer service delivery in daily interactions with internal and external colleagues.

• Bachelor's Degree and No Experience necessary / On-the-Job Training for those with a CPC or COC as the qualifying certification OR
• Associate's Degree and 1-2 years' experience, plus experience in revenue cycle, plus CPC or COC Cert OR
• High School diploma, or equivalent, and 3-5 years' experience, plus experience in revenue cycle, plus CPC or COC Cert
  • One of the following
    
    Required:
    
    Certified Professional Coder (CPC), Certified Outpatient Coder (COC), required upon hire

The benefits plans at Children’s Mercy are one of many reasons we are recognized as one of the best…