Denial Management Coordinator

This is a fully remote position, open to applicants in New York.

📋 Description

• Manage the coordination and monitoring of healthcare responses to denial inquiries.

• Assess the urgency of claims by analyzing due dates and their implications.

• Receive, document, and track all denial activities and communications.

• Keep an up-to-date database of all denial activities.

• Establish and sustain effective communication channels with internal insurance reviewers.

• Leverage aggregate denial activity data to advocate for policy enhancements.

• Collaborate closely with the Physician Advisor team to escalate issues and educate providers.

• Recognize recurring and overlapping issues and notify leadership.

• Create and prepare various reports for leadership review.

• Organize ad hoc meetings regarding urgent denial activities.

• Provide updates concerning process modifications and denial regulations.

⛳️ Requirements

• An Associate's degree or two or more years of relevant experience in the healthcare revenue cycle.

• Current certification as an RHIA, RHIT, RN, CCS, or CCS-P is preferred.

• Experience in coding, revenue cycle, and utilization management is preferred.

• Understanding of medical necessity, coding, and documentation guidelines for Medicare, Medicaid, and other third-party payers is preferred.

• Familiarity with Epic EHR is preferred.

• Experience in preparing and delivering educational materials to staff and providers is preferred.

🏝️ Benefits

• Health insurance

• Flexible work arrangements

• Professional development opportunities