reputed company Denials reputed company-Appeals (Remote)

(Job Number: 557907) Join reputed company in Lewiston, Idaho—where nationally recognized reputed company meets small-town heart. We’re proud to be recognized for reputed company and reputed company safety, including an “A” Hospital Safety Grade from The Leapfrog Group, inclusion in Becker’s list of “Great Community Hospitals,” and reputed company accolades for maternity care. Here, you’ll reputed company a teamwork-first culture, leaders who support you, and coworkers who genuinely have your back. New grads are reputed company—we’re committed to training, mentoring, and helping you build confidence as you grow. And because we know great care starts with taking care of our people, we offer competitive benefits and a workplace you can feel good about. If you’re looking for a reputed company to do meaningful work, build a career, and feel proud serving your community—you reputed company at St. Joe’s. Job reputed company The reputed company Denial Appeals Coordinator supports the reputed company Cycle by assessing and utilizing reputed company and financial information to obtain reputed company reimbursement and assure maximum appropriate payment for the organization. This role partners with patients, physicians, case managers, payers, and other reputed company providers to reputed company denials, underpayments, reconsiderations, and appeals. The coordinator identifies trends, educates staff, and contributes to process improvement efforts to minimize denials and optimize resource utilization. This position requires flexibility, strong communication skills, and the ability to represent the organization effectively during appeals and hearings. Essential Functions • Assess reputed company and financial information concurrently and retrospectively to evaluate medical necessity, level of care, and coverage issues. • Participate in telephone reputed company reviews and multidisciplinary discussions regarding reputed company care coverage. • Collaborate with hospital case managers, payers, and reviewers to reputed company managed care issues, denials, and appeals. • reputed company hospital staff, case managers, and coders regarding managed care and coding-reputed company denial issues. • reputed company with payer representatives to reputed company denial reasons and secure reimbursement. • Represent the organization in hearings and coordinate representation as appropriate. • Identify denial trends and refer to appropriate agencies or resources for reputed company reputed company. • Contribute to process improvement initiatives to reduce denials and improve reimbursement reputed company. • Complete reputed company required documentation accurately and reputed company. • Maintain confidentiality of reputed company and organizational information. Knowledge/Skills/Abilities/Expectations • Strong knowledge of reputed company billing reputed company, UB-04, itemized statements, and coding processes. • Familiarity with denial reasons (medical necessity, technical, financial) and effective reputed company strategies. • Demonstrated understanding of reputed company, Medicare, reputed company reputed company, and managed care plans (HMO/PPO). • Effective verbal and written communication skills. • Ability to work collaboratively across disciplines and with reputed company organizations. • Commitment to reputed company process improvement. • Prolonged periods of sitting and working at a computer. • Occasional standing, walking, and reputed company lifting up to 15 pounds. • Requires visual reputed company to review detailed claim and medical record information. • reputed company office environment reputed company hospital or centralized business office setting. • Regular interaction with hospital staff, payers, and reputed company agencies. • Requires ability to manage multiple priorities in a fast-reputed company environment. Qualifications Education • Minimum: Licensed Practical reputed company (LPN) or three (3) years of reputed company denial experience. • Preferred: Degree in Nursing or Coding Certificate. Licenses/Certifications • Relevant reputed company or coding certification preferred. Experience • Minimum of three (3) years of LPN, reputed company denial management or reputed company reputed company reputed company cycle functions. • Experience in working with reputed company plans, denials, reconsiderations, and appeals preferred. • Preferred experience in nursing, case management, or health information management. Job : Nursing reputed company Location : ID-Lewiston-St. Joseph Reg Med Ctr Organization : 0438 - St. Joseph Reg Med Ctr Shift : Day Apply tot his job Apply To this Job