Denials Prevention Coordinator
Maintains a professional image and exhibits excellent customer relations to patients, visitors, physicians, and co-workers in accordance with our Service Excellence Standards and Core Values.
Provide operational expertise, direction, and input to other departments as it relates to denials issues.
Serves as primary liaison between Managed Care and Payor Relations and other organizational departments to provide information regarding denial trends and projects that can be implemented on the local campuses to reduce denials.
Analyzes denial trends for organizational education purposes
Research online medical bulletins, policies, and authorization requirements for payers.
Participate and lead Denials Prevention meetings with other organizational stakeholders
Create and report all data requested for Denials reporting utilizing various software packages.
Skills in planning, leading, facilitating, and implementing improvement projects/teams.
Performs other duties as assigned by Director.
Work Schedule: 80 Hours bi-weekly
Experience with data manipulation, word processing, spreadsheets, and data analysis to report trends/patterns/statuses. Must be proficient with Microsoft Excel, Work, and PowerPoint.
Working knowledge of managed care terminology, managed care reimbursement methodologies, and billing/coding terminology (i.e ICD-10, CPT, Revenue Codes) preferred.
Complete working knowledge of all aspects of the revenue cycle
Excellent interpersonal, written and organizational skills required.
Experience in a progressive healthcare environment with responsibilities for data analysis preferred. Attention to detail and accuracy skills required.
Report writing experience preferred.
Must be flexible, able to work independently and able to achieve deadlines and deliverables with minimal supervision.
Experience with problem solving techniques.
Bachelor Degree in Business or Healthcare with 3 years of experience in healthcare revenue cycle preferred. Associates Degree with 6 years of experience in healthcare revenue cycle or High School Diploma with 10 years of experience in healthcare revenue cycle required or any equivalent combination of education and experience that provides the knowledge & skill required to perform the job duties.
Florence, SC, United States