Denials Management Coordinator - On-site
Denials Management Coordinator - On-site
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Job Description
At Central Maine Healthcare our team members are committed to providing exceptional care and experiences for our community and for each other every day.
Central Maine Healthcare is seeking a Denials Management Coordinator to join our Patient Financial Services Team.
This is a full time 40-hour benefits eligible position.
The rate of pay is $22.00 per hour.
The Denials Management Coordinator is responsible for applying fundamental knowledge of billing coding and payer requirements as it relates to researching analyzing and resolving denials contractual underpayments and credits. This job requires regular outreach to payers and internal stakeholders.
Education and Experience:
1. 2 Year Degree or 6 years healthcare experience
2. Six or more years of experience in health care billing functions
3. Ability to perform assigned tasks efficiently and in timely manner.
4. Ability to work collaboratively and effectively with people.
5. Exceptional communication and interpersonal skills.
6. Basic skills - demonstrates ability to organize perform and track multiple tasks accurately in short timeframes; able to work quickly and accurately in a fast-paced environment while managing multiple demands; able to work both independently and collaboratively as a team player; demonstrates adaptability analytical and problem-solving skills and attention to detail
What Its Like Working At CMH:
We are all about our team members growth and health. That why we prioritize work/life balance community-based wellness initiatives and tuition reimbursement or student loan repayment for ALL of our team members.
CMH offers a robust benefits package that includes:
- Robust Paid Time Off (PTO) program
- Medical plan with enhanced Tier 1 benefits provided within the CMH system.
- Dental plan
- Vision plan
- Health Savings Account (HSA)
- Basic Life insurance at no cost
- Supplemental Life insurance
- Long-term disability insurance
- 401(k) or 403(b) retirement savings plans
- Tuition IO partnership for student loan repayment assistance and tuition assistance
- Family leave program for Parental Leaves
- Comprehensive Wellness Program
Duties include but are not limited to:
1. triaging incoming variance inventory
2. validating appeal criteria is met in compliance with departmental policies and procedures
3. composing technical denial language for reconsideration including both written and telephonic
4. ensuring high level of competence in process and payer knowledge to overcome objections that prevent payment of the claim
5. gaining commitment for payment through concise and effective appeal composition
6. identifying problem accounts/processes/trends and escalate as appropriate
7. utilizing effective documentation standards that support a strong historical record of actions taken on the account
8. resolving the account (posting correct contractual adjustments posting other non-cash related Explanation of Benefits (EOB) information updating the patient accounts as appropriate
9. submitting uncollectible claims for adjustment timely and correctly
10. resolving claims impacted by payer recoupments refunds and posting errors
11. meeting and maintaining established departmental performance metrics for production and quality
12. maintaining working knowledge of workflow systems and tools used in the department
13. practicing and adhering to the Code of Conduct philosophy and Mission and Value Statement
14. maintaining collaborative approach to problem solving working with other revenue cycle teams and revenue generating areas
15. other duties as assigned
16. resolving accounts to 0 insurance balance
If you are passionate about making a difference and are looking for your next great career opportunity we look forward to reviewing your application!
Required Experience:
IC
Employment Type
Full-Time
