Job Description
The Denials Coordinator is responsible for working assigned denials and appeals claims by communicating with all necessary departments to identify and resolve denials trends and issues.
Essential Duties and Responsibilities: include the following. Other duties may be assigned.
- Complete monthly denial logs in required timeframe
- Attend monthly denial meetings with facilities as assigned
- Communicate with all necessary departments to identify and resolve denial trends and issues
- Review and analyze all denial trends and issues as assigned
- Maintain working knowledge of all payer guidelines and requirements as they relate to denials and appeals.
- Monitor and work all denials and appeals as assigned
- Properly track and document all denial and appeal activity.
- Maintain all logs, account notes and system records as assigned
- Review outpatient RAC denials and appeal as needed
- Monitor AB rebills that needed on RAC accounts and post recovery or denial adjustments as needed
- Monitor assigned duties in C, and ensure proper handling of all RAC accounts
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed
below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions.
Knowledge/Abilities:
Required
- Working knowledge of denials and appeal processes including a basic understanding of contracts and payer policies
- Working knowledge of current medical terminology
- Working knowledge of the revenue cycle
- Ability to communicate effectively both verbal and written
- Ability to work independently and to meet deadlines
Preferred
- Minimum of one year experience in a healthcare setting
- Working knowledge of the revenue cycle
Reasoning Ability: Ability to define problems, collect data, validate data, establish facts, and draw valid conclusions
Computer Skills:
Required
- Working knowledge of Outlook, Microsoft Word and Excel or equivalent
Certificates and Licenses: None required
Supervisory Responsibilities: None
Education/Experience:
Required
- High school diploma or equivalent
- Minimum of one year experience in a healthcare setting
Shared Services Center - Nashville
Nashville Tennessee
United States
Customer Service / Call Center
(No Timezone Provided)
Job Description
The Denials Coordinator is responsible for working assigned denials and appeals claims by communicating with all necessary departments to identify and resolve denials trends and issues.
Essential Duties and Responsibilities: include the following. Other duties may be assigned.
- Complete monthly denial logs in required timeframe
- Attend monthly denial meetings with facilities as assigned
- Communicate with all necessary departments to identify and resolve denial trends and issues
- Review and analyze all denial trends and issues as assigned
- Maintain working knowledge of all payer guidelines and requirements as they relate to denials and appeals.
- Monitor and work all denials and appeals as assigned
- Properly track and document all denial and appeal activity.
- Maintain all logs, account notes and system records as assigned
- Review outpatient RAC denials and appeal as needed
- Monitor AB rebills that needed on RAC accounts and post recovery or denial adjustments as needed
- Monitor assigned duties in C, and ensure proper handling of all RAC accounts
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed
below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions.
Knowledge/Abilities:
Required
- Working knowledge of denials and appeal processes including a basic understanding of contracts and payer policies
- Working knowledge of current medical terminology
- Working knowledge of the revenue cycle
- Ability to communicate effectively both verbal and written
- Ability to work independently and to meet deadlines
Preferred
- Minimum of one year experience in a healthcare setting
- Working knowledge of the revenue cycle
Reasoning Ability: Ability to define problems, collect data, validate data, establish facts, and draw valid conclusions
Computer Skills:
Required
- Working knowledge of Outlook, Microsoft Word and Excel or equivalent
Certificates and Licenses: None required
Supervisory Responsibilities: None
Education/Experience:
Required
- High school diploma or equivalent
- Minimum of one year experience in a healthcare setting