HIM DENIAL AUDIT TECH

Covenant HealthCare; Saginaw (MI); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Comprehensive medical, dental, and vis

Retirement plans with employer match

Paid time off

Wellness programs

Tuition reimbursement and development

Job summary

Covenant HealthCare in Michigan is seeking a Release of Information support specialist to assist the HIM team with mail processing, auditing, and denial tracking. You will help prepare appeals, manage provider portal uploads, and ensure timeliness of requests under HIPAA guidelines.

Strong accuracy, communication, and customer service are essential. Ideal candidates hold an associate degree with RHIA/RHIT eligibility and experience in healthcare; Epic knowledge is highly preferred to support

Qualifications

• Associate degree required.
• RHIA/RHIT or eligible for accreditation preferred.
• Medical terminology required.
• Knowledge of healthcare, HIM, Coding and Epic is strongly desired.
• Experience in a healthcare setting preferred.
• Preference for medical record experience in acute care setting.

Responsibilities

• Assists with mail processing.
• Track and monitor denial/audit release requests from billing, denials and coding teams in all formats.
• Assist in preparing appeals via mailing, faxing and provider portals.
• Submit and monitor medical record requests for payor requirements to ensure timeliness.
• Abide by HIPAA and Covenant Values.
• Demonstrate excellent customer service.
• Collaborate with outside vendors or payer contacts to improve processes.
• Work with spreadsheets, graphs, MS Office or similar documents.
• Participate in Process Improvement activities.
• Active participant on Denials Audit Committee, compiling analytics.

Skills

Time management

Prioritization

Independent and self-motivated

Communication skills

Attention to detail

Customer service

Education

Associate degree

RHIA/RHIT or eligible

Tools

Epic

Job description

Overview

This position will provide support to the Release of Information process up to and including managing audits/denials. This position will also provide assistance to the HIM Manager and HIM Coordinator, supporting tasks that lead to more efficient processes, tracking and monitoring as part of the Revenue Cycle. Organizational and computer skills, attention to accuracy and details and a willingness to work with many others is a requirement. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation.

Responsibilities

• Assists with mail processing.
• Track and monitor denial/audit release requests from the billing, denials and coding teams in all formats mail, email, fax.
• Assists in preparing appeals to include mailing, faxing and uploading to provider portals.
• Submit and monitor medical record requests for specific payor requirements (such as Predictive modeling) to ensure timeliness in response.
• Abide by HIPAA and Covenant Values
• Demonstrate excellent customer service
• May be required to work with outside vendors, payer contacts or others when working to improve processes
• Required to work on spreadsheets, graphs, Microsoft Office or other forms and documents
• Participating in Process Improvement activities
• Active participant on Denials Audit Committee, including compiling analytics and providing feedback to the group.
• Complete other projects or tasks as needed or assigned.

Qualifications

• Associate degree required
• RHIA/RHIT or eligible for accreditation preferred
• Medical terminology required
• Knowledge of healthcare, HIM, Coding and Epic is strongly desired
• Experience in a healthcare setting preferred
• Preference will be given to those individuals with previous medical record experience in an acute care setting
• Must demonstrate a positive and enthusiastic attitude in all interactions

Knowledge/Skills/Abilities

• Excellent time management to achieve maximum productivity
• Ability to prioritize workload and complete tasks on time
• Must be independent and self-motivated with a sound ability to reason and solve problems
• Must be able to demonstrate a positive and enthusiastic attitude in all interactions
• Must possess initiative and appropriate technical skills necessary to keep abreast of the latest legal developments regarding confidentiality, right to privacy and release of information.
• Must be able to communicate well, both verbally and in writing with patients, attorneys, physicians, government agencies, other health care facilities, insurance representatives, and the public
• Excellent customer service skills
• Attention to detail and accuracy is required.

Working Conditions / Physical Demands

• Ability to maintain regular punctual attendance consistent with ADA, FMLA and other federal, state and local standards
• Constant sitting, handling, fingering, feeling, talking and hearing
• Constant near, midrange and far vision
• Constant lifting 0-10 lbs Frequent depth perception, color and field vision
• Frequent standing, walking, sitting and far vision.
• Occasional lifting, pushing, pulling, stooping, kneeling, crouching, crawling, twisting, or reaching
• Occasional lift up to 50 lbs

Why Work at Covenant HealthCare

At Covenant HealthCare, we are united by a shared mission of providing Extraordinary Care for Every Generation. We foster a culture built on teamwork, excellence, accountability, respect, customer service, and enthusiasm, where every employee plays an important role in delivering patient-centered care and making a difference in our community.

Our Benefits Include

• Comprehensive medical, dental, and vision coverage
• Retirement plans with employer match
• Paid time off to support work-life balance
• Employee wellness programs and mental health support
• Tuition reimbursement, university discounts, and professional development opportunities