DENIAL COORDINATOR (13701)

Cullman Regional; Cullman (AL); On-site; USD 42,000 - 64,000; Full time

Job summary

Cullman Regional Medical Center in Cullman, AL is seeking a Medical Billing Denials Specialist to analyze claim denials, perform follow up, and help maximize reimbursements across the revenue cycle.

The role requires at least 3 years of medical billing experience, a high school diploma (some college preferred), and strong communication, confidentiality, and teamwork skills to collaborate with offices, billing and coding staff to improve denial management.

Qualifications

• Education requirement: High school diploma; some college preferred.
• Experience: minimum three years in Medical Billing.
• Healthcare billing knowledge and denial handling.

Responsibilities

• Analyzes claim denials and executes follow up to recover payment.
• Assists with provider credentialing and payor enrollment to maintain provider status and research denials.
• Coordinates with multiple departments to determine root causes of denials.
• Maintains a tracking log to monitor post-payment review findings and appeals.
• Identifies patterns in payor denials and reports recurring issues to management.
• Assists with claim submission, follow-up, and reporting needs throughout the clinically driven revenue cycle.
• Submits payer reconsiderations and appeals as necessary and completes follow-up for final resolution.
• Assists in the clinical revenue cycle to achieve the maximum appropriate reimbursement.
• Retrieves paper and electronic claims and remittance advice reports where necessary to overcome denials.
• Enters accurate and thorough documentation of pertinent events regarding the handling of the denial.
• Meets established production standards.
• Works in a collaborative fashion with the office, billing, and coding staff to improve overall processes.

Skills

Self-directed

Communication skills

Interpersonal skills

Teamwork

Customer service

Confidentiality

Independent work

Education

High school diploma

Some college coursework

Job description

Job Details

Job Location

Cullman Regional Medical Center - Cullman, AL 35056

Position Type

Full Time

Job Shift

Day

Job Category

Health Care

Job Summary

• Analyzes claim denials and executes follow up to recover payment
• Assists with provider credentialing and payor enrollment to maintain provider status and research denials
• Coordinates with multiple departments as needed to determine the root causes of denials
• Maintains a tracking log to monitor post-payment review findings and appeals
• Identifies patterns in payor denials and reports recurring issues to management
• Assists with claim submission, follow-up, and reporting needs throughout the clinically driven revenue cycle
• Submits payer reconsiderations and appeals as necessary and completes follow-up for final resolution
• Assists in the clinical revenue cycle to achieve the maximum appropriate reimbursement
• Retrieves paper and electronic claims and remittance advice reports where necessary to overcome denials
• Enters accurate and thorough documentation of pertinent events regarding the handling of the denial
• Meets established production standards
• Works in a collaborative fashion with the office, billing, and coding staff to improve overall processes

Qualifications

• Education: High school diploma required. Some college coursework in a healthcare, business, or related field preferred.
• Experience: Minimum three (3) years working in Medical Billing.

Additional Skills/Abilities

• Must be self-directed / self-motivated; must have good communication and interpersonal skills. Must be able to: (1) perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure; (2) work independently; (3) recognize the rights and responsibilities of patient confidentiality; (4) relate to others in a manner which creates a sense of teamwork and cooperation; and (5) maintain a customer focus and strive to satisfy the customer's perceived need.