Denial Mitigation Lead — Oncology Revenue Cycle

Baptist Memorial Health Care Corporation; Memphis (TN); On-site; USD 70,000 - 95,000; Full time

Job summary

Baptist Memorial Health Care Corporation is seeking a Denial Mitigation Lead to support the Denial Mitigation Department across oncology and hospital services. The role guides Financial Counselors, Authorization/Appeal Specialists, Denial Specialists and Denial Analysts to ensure timely processing in line with payer policies and hospital procedures.

The position involves collaboration with clinical oncology and revenue cycle teams to meet metrics, mentor staff, and implement process improvements

Qualifications

• Minimum Required education and experience in healthcare revenue cycle

Responsibilities

• Assist Supervisor/Manager in overseeing work assignments of staff responsible for financial applications, authorization, appeals, and correspondence for oncology and hospital services across BMHCC
• Assist in providing educational tools and continued education for the team related to oncology drugs and outpatient services to meet medical necessity guidelines and obtain authorizations/appeals
• Assist Supervisor/Manager with preparing information for staff meetings to keep staff informed of payer updates, workflow changes, and other information as appropriate
• Responsible for monitoring all assigned workqueues to ensure timelines are met for authorizations, appeals, triage reviews, retros, timely write-offs and reporting insufficiencies
• Coordinate with internal and external customers to identify opportunities for improvement
• Report system or payer issues and assist in implementing changes
• Contribute to staff training and education on denial mitigation and payer guidelines
• Conduct site visits for education of staff and new hires
• Ensure customer satisfaction through communication and efficient processes
• Maintain HIPAA compliance and department policies
• Collaborate with Clinic Directors to develop workflows and address issues
• Research with the Director Denial Mitigation on denials by Medicare, Medicaid, Tricare, commercial payers and Managed Care
• Perform other duties as assigned

Skills

Microsoft Office

Data entry

Process improvement

Education

High school diploma or equivalent

Associate or Bachelor’s degree in related field

RHIT / CRCR or related credential

Tools

Microsoft Excel

Job description

Baptist Memorial Health Care Corporation is seeking a Denial Mitigation Lead to support the Denial Mitigation Department across oncology and hospital services. The role guides Financial Counselors, Authorization/Appeal Specialists, Denial Specialists and Denial Analysts to ensure timely processing in line with payer policies and hospital procedures.

The position involves collaboration with clinical oncology and revenue cycle teams to meet metrics, mentor staff, and implement process improvements