Coordinator, Denial Management Professional Billing (On Site, Hybrid)

Northbay Health; Fairfield (CA); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

403(b) retirement plan with employera

Education reimbursement

Paid time off

Wellness programs

Job summary

NorthBay Health is seeking a Coordinator, Denial Management to monitor, analyze, and coordinate professional fee denials and underpayments. You will work with the PFS division, practice operations, providers, and staff to create reports, monitor trends, and provide corrective oversight for billing and contractual reimbursement issues.

The role requires 3+ years in related billing with CPT/ICD/HCPCS knowledge and HFMA CRCR training within 9 months.

Qualifications

• Associate degree or equivalent with at least 3 years in related work.
• 5 years in professional billing with CPT/ICD/HCPCS knowledge.
• HFMA CRCR training within 9 months of employment.

Responsibilities

• Create, review, and analyze payer underpayment and variance reports weekly.
• Utilize EHR, billing systems, payer portals, and Microsoft Office tools effectively.
• Research and evaluate denial and underpayment trends; propose process improvements.
• Plan, organize, and prioritize workload to manage high volumes of data accurately and efficiently.
• Provide training to the PFS team based on data analysis and identified trends.
• Collaborate with other departments to resolve denials and improve reimbursement processes.

Skills

Denial management

CPT/HCPCS coding

HIPAA knowledge

Data analysis

Excel

EHR systems

Payer contracts

Training staff

Attention to detail

Communication

Education

Associate’s degree

Tools

Billing systems

Payer portals

EHR systems

MS Office

Job description

Job Description

At Northbay Health, the Coordinator, Denial Management is responsible for the monitoring, analytics, reporting, and coordination of professional fee healthcare claims denials and underpayments. The incumbent works with the PFS division, practice operations, providers, and other facility staff to create reports, monitor trends, and provide feedback, training, and corrective oversight related to billing, coding, and contractual reimbursement issues identified through claim denials, edits, and underpayments. The purpose of this role is to ensure appropriate reimbursement in accordance with payer contracts and applicable government fee schedules.

Job Description

At Northbay Health, the Coordinator, Denial Management is responsible for the monitoring, analytics, reporting, and coordination of professional fee healthcare claims denials and underpayments. The incumbent works with the PFS division, practice operations, providers, and other facility staff to create reports, monitor trends, and provide feedback, training, and corrective oversight related to billing, coding, and contractual reimbursement issues identified through claim denials, edits, and underpayments. The purpose of this role is to ensure appropriate reimbursement in accordance with payer contracts and applicable government fee schedules.

Primary Job Responsibilities

• Create, review, and analyze payer underpayment and variance reports; distribute findings weekly and recommend corrective actions.
• Utilize EHR, billing systems, payer portals, and Microsoft Office tools effectively.
• Research and evaluate denial and underpayment trends; propose process improvements.
• Plan, organize, and prioritize workload to manage high volumes of data accurately and efficiently.
• Participate in meetings, training sessions, and team development activities.
• Maintain current knowledge of eligibility requirements, payer guidelines, government regulations, and industry standards.
• Demonstrate a comprehensive understanding of billing procedures, HIPAA 837P/835 transactions, CMS-1500, UB-04, CARC/RARC codes, and common claim edits.
• Provide training to the PFS team based on data analysis and identified trends.
• Collaborate with other departments to resolve denials and improve reimbursement processes.
• Perform other duties as assigned.

Qualifications

Education

• Associate’s degree preferred, or an equivalent combination of education and/or at least 3 years of related experience.

Licensure/Certification

• All new hires will be required to complete the HFMA Certified Revenue Cycle Representative (CRCR) training course within the first nine (9) months of employment.
• Membership, training, and certification costs will be sponsored by the employer.

Experience

• 5 years of experience in professional billing, with in‑depth knowledge of CPT, ICD, and HCPCS coding.
• Understanding of payer contracts, payment structures, and federal/state regulations.
• Proficiency with compliance laws and collection laws.

Skills

• Excellent oral and written communication skills.
• Proficiency in PC applications and Microsoft Office Suite, especially Excel.
• Strong analytical skills with attention to detail.
• Skilled in training and providing education to staff.
• Strong organizational skills.

Interpersonal Skills

• Ability to prioritize tasks and communicate delays effectively.
• Communicate clearly across all organizational levels.
• Collaborate effectively with team members for professional communication and inclusion.

Standards of Performance

• Demonstrate performance by adhering to established policies and procedures and exhibiting the defined characteristics associated with attendance and punctuality.

Physical Effort

• Attendance is an essential function of the job.
• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

About Us

Interpersonal Skills and Values

Demonstrates NorthBay Health’s True North Values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high‑quality patient care.

Why NorthBay Health

NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute‑care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.

We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions.

We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities.

NorthBay Health Benefits Options

NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long‑term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market‑based compensation review and increases subject to approval and organizational performance.

Compensation Structure

NorthBay Health uses a structured compensation framework. Staff‑level positions use a step‑based system (Steps 1–5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements.

Remote Work Disclosure

NorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs.

Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States.

Notice to Recruitment Agencies

NorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third‑party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings.

More Information

Visit NorthBay Health Careers for recruitment FAQs and additional information.