Denials & Appeals Coordination Specialist

McLaren Health Care; Grand Blanc (MI); In loco; USD 42.000 - 62.000; Tempo pieno

Descrizione del lavoro

McLaren Health Care is seeking a Denials Clerk to support the Denials Team in coordinating CMS and third-party payer denials and appeals, and perform clerical functions to ensure efficient operation.

You will assist in determining inpatient vs observation based on medical necessity, maintain knowledge of billing processes, and help track and report denial data.

The role requires a high school diploma, clerical experience, and familiarity with medical terminology; BLS certification is preferred.

Competenze

• High school diploma is required.
• One-year healthcare environment experience using medical terminology or relevant coursework.
• Two years of clerical experience.

Mansioni

• Assist the Denials Team in CMS and third-party payer denials/appeals.
• Determine inpatient vs. observation based on medical necessity.
• Support resolution of retrospective billing issues and denied cases.
• Communicate with A/R, denials, finance/billing, and HIM to provide information for appeals.
• Attend meetings and prepare agendas/minutes.

Conoscenze

Clerical experience

Medical terminology knowledge

Formazione

High school diploma

Associate degree in healthcare related field

Descrizione del lavoro

McLaren Health Care is seeking a Denials Clerk to support the Denials Team in coordinating CMS and third-party payer denials and appeals, and perform clerical functions to ensure efficient operation.

You will assist in determining inpatient vs observation based on medical necessity, maintain knowledge of billing processes, and help track and report denial data.

The role requires a high school diploma, clerical experience, and familiarity with medical terminology; BLS certification is preferred.