Denials & Appeals Strategist

ScionHealth; Philadelphia (Philadelphia County); On-site; USD 60,000 - 90,000; Full time

Job summary

ScionHealth is seeking a Denials & Appeals Coordinator to serve as the operational driver for denial prevention and resolution across facilities. You will partner with utilization management, case management, and the Centralized Business Office to ensure timely denial prevention and accurate documentation.

This role focuses on concurrent review for continued stay authorizations, data tracking, and reporting denial activity to regional leadership, driving quality improvements within a

Qualifications

• High school diploma or equivalent required.
• Associate degree in healthcare preferred; licensed provider considered.
• 2+ years of healthcare experience required.
• Experience in case management, medical records, billing, utilization review, or admissions preferred.
• Post-acute care or long-term care experience preferred.

Responsibilities

• Serve as CAAT subject matter expert on denial prevention and coordination.
• Gather clinical information from medical records and input into required systems.
• Ensure denial-related documentation is complete and submitted on time.
• Coordinate peer-to-peer physician consults and communicate outcomes.
• Monitor insurance denials and identify trends for improvement.
• Prepare reports on denial trends for facility and leadership.
• Maintain knowledge of payor practices and regulations; support analytics.

Skills

Teamwork

Communication skills

Attention to detail

Data entry

Computer literacy

Education

HS diploma

Healthcare associate degree

Licensed healthcare provider

Job description

ScionHealth is seeking a Denials & Appeals Coordinator to serve as the operational driver for denial prevention and resolution across facilities. You will partner with utilization management, case management, and the Centralized Business Office to ensure timely denial prevention and accurate documentation.

This role focuses on concurrent review for continued stay authorizations, data tracking, and reporting denial activity to regional leadership, driving quality improvements within a