Denial Coordinator
3 weeks ago
- 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 C360, and ensure proper handling of all RAC accounts
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.
Required Education and Experience
- High school diploma or equivalent
- Minimum of one year experience in a healthcare setting
- Working knowledge of the revenue cycle
- Working knowledge of denials and appeal processes including a basic understanding of contracts and payer policies
- Working knowledge of current medical terminology
- Ability to communicate effectively both verbal and written
- Ability to work independently and to meet deadlines
- Working knowledge of Outlook, Microsoft Word and Excel or equivalent
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