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Central Care Cancer Center is seeking a Denials Coordinator to manage and appeal denied insurance claims, recovering revenue for the center.
You will review denials, draft appeals with supporting clinical notes, and resubmit corrected claims to insurers. The role requires collaboration with coders, billers, and clinical staff to gather documentation and understand policy requirements.
The denials coordinator manages and appeals rejected healthcare insurance claims to recover revenue for Central Care Cancer Center.
Review Denied Claims: Examine insurance explanation of benefits and electronic medical records to find the exact reason for a claim denial.
Draft and Submit Appeals: Write appeal letters, attach clinical notes/medical records, and resubmit corrected claims to insurance companies.
Analyze Root Causes: Track denial trends and patterns to identify recurring billing, coding, or authorization errors and report them to management.
Collaborate Internally: Work with medical coders, billers, and clinical staff to gather missing documentation and clarify patient accounts.
Communicate with Payers: Contact third-party insurance providers via phone or online portals to check claim statuses and verify policy requirements.
High School Diploma, required. Associate's or Bachelor's Degree in Healthcare Administration, Business, or nursing is preferred.
1-4 years experience in medical and radiation oncology billing, revenue cycle management, (Medicare, Medicaid, and Commercial) claims processing, or insurance follow-up.
Familiarity with Electronic Health Records (EHR) and billing software, such as Meditech.
Understanding of medical coding standards (ICD-10, CPT, HCPCS) and insurance regulations.