Payer Audit Denial Coordinator — Revenue Recovery

UCHealth; Denver (CO); On-site; USD 37,000 - 56,000; Full time

Job summary

UCHealth in Denver is seeking a Denials Management professional to recover potential revenue from payer denials. The position is full-time, onsite with a day shift, and focuses on coordinating appeals and managing denial processes to improve reimbursement.

The ideal candidate has a nursing or healthcare-related degree with experience in coding, utilization, or denial management, plus BLS/CPR certification and strong analytical skills. Onsite role with comprehensive UCHealth benefits.

Qualifications

• 3 years of healthcare coding experience for inpatient and outpatient hospitals OR 3 years of experience in acute care nursing
• 1 year of Utilization or Case Management experience OR previous denial management experience
• BLS through the American Heart Association or the American Red Cross CPR for the Professional Rescuer with card in-hand before start date

Responsibilities

• Analyzes data to recover potential loss in revenue as a result of payer denials.
• Determines if appeals should be filed; initiates appeals and manages denied appeals within the timeframes and guidelines of each given payer.
• Coordinates response of other stakeholders in payer audits including legal counsel and health information management.
• Analyzes denial issues and pinpoints trends. Provides feedback regarding workflow improvement opportunities to leadership.
• Serves as a Recovery Audit Contractor (RAC) program subject matter expert. Works with the Government Audit Program Administrator to compile materials and reports with follow up communication.
• Participates in system wide audit activities. Applies industry standard criteria to assist in determination of the appropriate level of patient care.

Skills

Healthcare coding experience

Utilization

Denials management experience

Education

Associate's Degree in Nursing or healthcare related field

BLS/CPR for Healthcare Providers

Job description

UCHealth in Denver is seeking a Denials Management professional to recover potential revenue from payer denials. The position is full-time, onsite with a day shift, and focuses on coordinating appeals and managing denial processes to improve reimbursement.

The ideal candidate has a nursing or healthcare-related degree with experience in coding, utilization, or denial management, plus BLS/CPR certification and strong analytical skills. Onsite role with comprehensive UCHealth benefits.