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Infusion Denials and Reimbursement Expert

2 months ago

Jonesboro, Arkansas, United States St. Bernards Healthcare Full time
Job Summary

St. Bernards Healthcare is seeking a highly skilled Infusion Reimbursement Coordinator to join our team. The successful candidate will be responsible for monitoring, tracking, aggregating, and trending reimbursement and denials information according to discrete outpatient denial codes.

Key Responsibilities
  • Review and analyze information related to infusion denials and follow up with appropriate action through the reimbursement and denial process.
  • Work closely with the infusion center to prevent denials and ensure compliance with regulatory requirements.
  • Assist the UM Coordinator with denials and appeals, and close out each tracked denial (overturned or recouped).
  • Manage competing priorities, multi-task, and work in a fast-paced environment to increase revenue capture related to the infusion center.
  • Provide facility-wide resource support for denials/appeal process and regulatory compliance as it relates to the infusion center.
Requirements
  • Bachelor's Degree in Business or Healthcare Administration required.
  • 1-3 years of healthcare experience with knowledge of the reimbursement/denials process.
  • Knowledge of reimbursement systems, Federal, State, and payor-specific regulations pertaining to documentation and billing.
  • Excellent written and verbal communication skills, with ability to interact well with physicians, physician offices, and Business Office personnel.
  • Ability to work independently, with meticulous follow-up skills, organizational skills, prioritization skills, and experience working in a team environment.
Work Environment

The successful candidate will work in a normal hospital business office environment, with continuous sitting approximately 90% of the work day. The position requires the ability to operate a computer, calculator, copier, and general office equipment, with occasional walking, bending, and lifting of 5-10 pounds.