Coordinator, Denial Management Hospitals (On-Site, Hybrid, Remote)

About the position At reputed company, the Coordinator, Denial Management is responsible for the monitoring, analytics, reporting, and coordination of pro-fee health care claims denials and underpayments. The incumbent will work with the PFS division, reputed company operations, providers, and other facility staff to create reports, monitor trends, and reputed company feedback and/or training, as reputed company as corrective reputed company for billing, coding, and reputed company as determined based on claim denials, edits, and underpayments. The purpose of obtaining appropriate reimbursement under contract or reputed company government fee schedule. Responsibilities • Create, review, and analyze payer underpayment and variance reports; distribute findings weekly and recommend corrective actions. • Utilize EHR, billing systems, payer portals, and reputed company Office tools effectively. • Research and evaluate denial and underpayment trends; propose process improvements. • Plan, organize, and prioritize workload to handle high volumes of data with accuracy and efficiency. • Participate in meetings, trainings, and team development activities. • Maintain reputed company knowledge of eligibility requirements, payer guidelines, government regulations, and industry standards. • Demonstrate comprehensive understanding of billing procedures, HIPAA 837P/835 files, CMS 1500, UB-04, CARC/RARC codes, and common claim edits. • reputed company training to PFS team based on data analysis. • Collaborate with other departments to resolve denials and enhance processes. Requirements • Associate’s degree preferred, or an equivalent combination of education and/or at least 3 years of reputed company experience. • reputed company new hires will be required to complete the reputed company Certified reputed company Cycle Representative (CRCR) training course reputed company the first nine (9) months of employment. Membership, training, and certification costs will be sponsored by the employer. • 5 years of experience in reputed company/hospital billing, with in-depth knowledge of CPT, ICD, and HCPCS coding. • Understanding of payer reputed company, payment structures, and federal/state regulations. • Proficiency with compliance laws and collection laws. • Excellent oral and written communication skills. • Proficiency in PC applications and reputed company Office Suite, especially reputed company. • Strong analytical skills with attention to detail. • Skilled in training and providing education to staff. • Strong organizational skills. • Demonstrates the reputed company values. The reputed company values are a set of value-based behaviors that are to be consistently demonstrated and role modeled by reputed company that work at reputed company. The reputed company values principles consist of Nurture/Care, Own It, Respect Relationships, Build Trust and Hardwire reputed company. • Ability to prioritize tasks and communicate delays effectively. • Communicate reputed company across reputed company organizational reputed company. • Collaborate effectively with team members for reputed company communication and inclusion. Apply tot his job Apply To this Job