Professional Denials Specialist

5 days ago


Oklahoma City, Oklahoma, United States Oklahoma Heart Hospital Full time
Job Summary

Oklahoma Heart Hospital is seeking a highly skilled Professional Denials Specialist to join our team. As a key member of our revenue cycle department, you will play a critical role in improving collections and reducing open balances.

Key Responsibilities
  • Work with inpatient notices of admission, authorizations, and subsequent denials to identify trends and root causes.
  • Assist with first and second-level appeals under the guidance of a Denials Manager.
  • Prepare appeals on denials, including researching root cause, collecting required information, and resubmitting claims.
  • Collaborate with Denials Analyst and Underpayments Coordinator to identify areas of opportunity and system/process errors.
  • Submit requests to clarify clinical documentation for accurate coding of denials.
Requirements
  • High school graduate or equivalent preferred.
  • Minimum of two years of experience in professional/clinic insurance follow-up or denials.
  • Clinical denials experience is preferred; Epic experience is a plus but not required.
  • CPC is strongly encouraged.
What We Offer
  • Competitive benefits program.
  • Top-tier benefit packages, including medical, dental, and vision.
  • 401(k) plan.
  • Paid time off (PTO).
  • Extended medical benefit (EMB).


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