Revenue Cycle Denial Coordinator
1 week ago
We are seeking a highly skilled Revenue Cycle Denial Coordinator to join our team at Southern Illinois University School of Medicine. The successful candidate will be responsible for evaluating and resolving denied claims within the clinical departments at all SIU Federally Qualified Healthcare Centers.
Key Responsibilities- Perform timely and accurate review of coding related denials, appeal and submission, including tracking findings.
- Address denied claims and perform research to resolve coding related rejections.
- Review medical record and coded information to determine if coding needs to be changed or if an appeal is needed for resolution.
- Review all denial accounts for categorization, level of appeal, special requirements for initiating appeals.
- Create and maintain an appeal process for all outpatient, inpatient, and clinic denials.
- Utilize denial reports to assess root causes and identify trends.
- Monitor and track denial trends to help identify education/feedback opportunities.
- Proactively monitor Revenue Cycle communications and payer websites for policy and guideline changes.
- Perform other Coding functions as appropriate, including assisting with coding backlogs as necessary.
- Stay up-to-date with all federal, state and departmental coding guidelines and procedures.
- Attend department meetings to discuss denial trends and prevention opportunities.
- High School graduation or equivalent.
- Current certification as a Certified Coding Specialist (CCS) or Certified Coding Specialist-Physician-based (CCS-P) or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) by the American Health Information Management Association (AHIMA), or current certification as a Certified Professional Coder (CPC) or a Certified Outpatient Coder (COC) by the American Academy of Professional Coders (AAPC) (formerly CPC-H certification) or a Community Health-Certified Billing Specialist (CH-CBS).
- Three (3) years (36 months) of total work experience, two (2) years (24 months) of which are comparable to that performed at the Reimbursement Coding Specialist level of this series or in other positions of comparable responsibility.
We offer a comprehensive benefits package, including health, dental, and life insurance, paid time off, and tuition reimbursement. We are an equal opportunity employer and welcome applications from diverse candidates.
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