Denials Management & Appeals Coordinator

Memorial Health System (Ohio); Reno (OH); On-site; USD 60,000 - 80,000; Full time

Job summary

Memorial Health System (Ohio) seeks a Denials Management Coordinator to analyze denial patterns and educate frontline staff on proper processes. You will articulate appeal details to insurers and document results in the hospital system, while preparing management reports on audits and systemic errors.

The role includes monthly prevention observations and other duties as needed. The position emphasizes strong analytical skills, negotiation abilities, and proficiency with payor and hospital coding

Qualifications

• HS Diploma or GED required.
• Minimum of two years of healthcare-related experience required.
• Experience in coding, medical necessity, registration, insurances and precertification processes and/or denials preferred.
• 2+ years of experience or formal education in ICD10 coding, medical terminology, anatomy/pathophysiology and disease process preferred.
• Coding certification within 2 years of hire may be required depending on experience.

Responsibilities

• Analyzes all denials for patterns.
• Works with front line staff and educates on proper processes.
• Verbalizes to insurance carriers and writes appeal details to support additional payment on denied claims.
• Documents results of all denial reviews in the hospital information system.
• Prepares reports on audit results, process improvement recommendations and systemic payment errors.
• Makes monthly observations and recommendations to prevent future denials.
• Assumes other duties and responsibilities as necessary.

Skills

Analytical skills

Negotiation skills

Computer skills

Oral and written communication

Team collaboration

Medical records and billing knowledge

Education

HS Diploma or GED

ICD-10 coding / medical terminology knowledge

Tools

Hospital information systems

Coding methodologies

Job description

Memorial Health System (Ohio) seeks a Denials Management Coordinator to analyze denial patterns and educate frontline staff on proper processes. You will articulate appeal details to insurers and document results in the hospital system, while preparing management reports on audits and systemic errors.

The role includes monthly prevention observations and other duties as needed. The position emphasizes strong analytical skills, negotiation abilities, and proficiency with payor and hospital coding