Denials Management Coordinator - Denials Management biweekly

Job Details

Job Location:

Reno, OH 45750

Position Type:
Full Time

Job Shift: 8-Hour Day Shift

Job Category:
Clerical Support

• Analyzes all denials for patterns.
• Works with front line staff and educates on proper processes.
• Ability to verbalize to insurance carriers and write appeal details to support additional payment on denied claims.
• Accurately and consistently documents the results of all denial reviews in the hospital information system.
• Prepares reports as required by management regarding audit results, process improvement recommendations and systemic payment errors.
• Makes monthly observations and recommendations to prevent future denials.
• Assumes all other duties and responsibilities as necessary.

• High School Diploma or GED required.
• Minimum of two years of previous experience in a healthcare-related position required.
• Experience in coding, medical necessity, registration, insurances, and precertification processes and/or denials preferred.
• Minimum of 2 years of experience or formal education in basic ICD
  10 coding, medical terminology, anatomy/pathophysiology, and disease process preferred.
• Depending on healthcare-related experience, may require coding certification within 2 years of date of hire. Experience reviewing ambulatory claim denials preferred.

• Computer skills (word processing, spreadsheet, graphics, and database software applications).
• Strong quantitative, analytical and organization skills.
• Strong negotiation skills.
• Proficient in payment review systems, hospital information systems and coding methodologies.
• Ability to understand medical records, hospital bills, and the charge master.
• Ability to understand all ancillary department functions for the facility.
• Ability to understand complex insurance terms and payment methodologies.
• Ability to effectively negotiate with insurance carriers and customers.
• Ability to utilize and understand computer technology.
• Ability to communicate orally and in written form.
• Team-orientated with strong interpersonal skills.

Education, experience, and tenure may be considered along with internal equity when job offers are extended.

Memorial Health System is proud to offer an affordable, comprehensive benefit package to all full time and flex time employees. To learn more about the many benefits we offer, please visit our website ystem.org/benefits.

Available to qualifying full or flex time employees. Eligibility will be determined upon offer.

Memorial Health System is an equal opportunity provider and employer.

Memorial Health System is a federal drug-free workplace.