Professional Denials Coordinator

Oklahoma Heart Hospital; Oklahoma City (OK); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical, Dental, Vision

401(k) with employer match

Disability insurance

EAP

Paid Time Off

Education/professional growth

Job summary

Oklahoma Heart Hospital in Oklahoma City is seeking a Professional Denials Coordinator to improve collections by targeting insurance denials and reducing open balances. You will handle inpatient notices of admission, authorizations, and subsequent denials with guidance from the Denials Manager.

You will assist in appeals, identify root causes, and help prevent future denials through data-driven findings and collaboration with the Denials team.

Qualifications

• Minimum of two years in professional/clinic Insurance Follow-Up or Denials.
• Clinical denials experience preferred; CPC encouraged.
• Strong understanding of insurance collections and denials processes.

Responsibilities

• Work under the guidance of the Denials Manager to prepare appeals on denials.
• Defend and appeal claims, researching root causes and gathering information.
• Submit requests to clarify clinical documentation for accurate coding of denials.
• Collaborate with Denials Analyst and Underpayments Coordinator to identify opportunities.

Skills

Insurance follow-up

Denials handling

Team collaboration

Education

High school diploma or equivalent

CPC certification encouraged

Tools

Epic experience

Job description

Overview

Join Our Team at Oklahoma Heart Hospital (OHH). ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients' journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we're shaping the future of heart care in Oklahoma by serving the state and leading the nation.

Location: Hartford: 7800 NW 85th Terrace, OKC OK 73132

Shift: Full-Time, Days Monday-Friday.

Benefits

• Comprehensive Benefits:
  • Medical, Dental, and Vision coverage
  • 401(k) plan with employer match
  • Long-term and short-term disability
  • Employee Assistance Programs (EAP)
  • Paid Time Off (PTO)
  • Extended Medical Benefits (EMB)
  • Opportunities for continuing education and professional growth
• Please note that benefits may vary by position, and some roles (like PRN, Flex, Float, etc.) may have exclusions. For eligible positions, benefits start on your first day!

Responsibilities

The Professional Denials Coordinator will work on targeted insurance denials to improve collections and reduce open balances. They will deal with inpatient notices of admission, authorizations, and subsequent denials. The Professional Denials Coordinator will assist with first and second level appeals under the Denials Manager's guidance. The Denials Coordinator will assist in identifying trends and finding root causes to prevent future denials, providing high-impact findings to the Denials Manager.

• Works under the guidance of a Denials Manager and Denials RN to prepare appeals on denials.
• Defend and appeal claims, including researching root cause, collecting required information, adjusting the account as necessary, resubmitting claims and all appropriate follow up activities.
• Submits requests to clarify clinical documentation for accurate coding of denials.
• Works with Denials Analyst and Underpayments Coordinator to call attention to areas of opportunity or system/process errors.

Qualifications

• Education: High school graduate or equivalent preferred.
• Experience: Minimum of two (2) years in professional/clinic Insurance Follow-Up or Denials. Clinical Denials experience is preferred; Epic experience is a plus but not required. CPC is strongly encouraged.
• Working Knowledge: Insurance collections and denials, with an emphasis on professional coding is preferred.

As part of our team, you are empowered to work collaboratively with our physicians and other caregivers, and play an integral role in setting the standard for excellence in patient care. Every team member at OHH plays an integral role in our patients' experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care.