Denials Management Coordinator - Denials Management - FT 1.0 (80 hrs biweekly) (69064)

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    "jobTitle": "Denials Management Coordinator - Denials Management - FT 1.0 (80 hrs biweekly) (69064)",
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    "description": "<div style=\"margin-left:-1px;\">\n<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">In an environment of continuous quality improvement, the Denials Management Coordinator is responsible for reviewing all denials to determine patterns in errors, payors, and internal processes to improve our denial rate. Exhibits the MHS Standards of Excellence and exercises strict confidentiality at all times. </span></span></span></span></p>\n\n<p> </p>\n\n<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#1f3864;\">Job Functions:</span></span></span></strong></span></span></p>\n\n<ol>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Analyzes all denials for patterns.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Works with front line staff and educate on proper processes.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Ability to verbalize to insurance carriers and write appeal details to support additional payment on denied claims. </span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Accurately and consistently documents the results of all denial reviews in the hospital information system.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Prepares reports as required by management regarding audit results, process improvement recommendations and systemic payment errors.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Makes monthly observations and recommendations to prevent future denials.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Assumes </span></span><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">all other duties and responsibilities as necessary.</span></span></span></span></li>\n</ol>\n</div>",
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Experience reviewing ambulatory claim denials preferred. </span></span></span></span></li>\n</ul>\n\n<p> </p>\n\n<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#1f3864;\">Special Knowledge, Skills, Training:</span></span></span></strong></span></span></p>\n\n<ul>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Computer skills (word processing, spreadsheet, graphics, and database software applications).</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Strong quantitative, analytical and organization skills.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Strong negotiation skills.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Proficient in payment review systems, hospital information systems and coding methodologies.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Ability to understand medical records, hospital bills, and the charge master.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Ability to understand all ancillary department functions for the facility.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Ability to understand complex insurance terms and payment methodologies.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Ability to effectively negotiate with insurance carriers and customers.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Ability to utilize and understand computer technology.</span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Ability to communicate orally and in written form. </span></span></span></span></li>\n\t<li><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Team-orientated with strong interpersonal skills. </span></span></span></span></li>\n</ul>\n\n<p> </p>\n\n<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#1f3864;\">Compensation Details: </span></span></span></strong> <span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Education, experience, and tenure may be considered along with internal equity when job offers are extended.</span></span></span></span><br />\n </p>\n\n<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#1f3864;\">Benefits:  </span></span></span></strong><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Memorial Health System is proud to offer an affordable, comprehensive benefit package to all full time and flex time employees.  To learn more about the many benefits we offer, please visit our website at </span></span><a href=\"http://www.mhsystem.org/benefits\" target=\"_blank\" rel=\"noreferrer noopener\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">www.mhsystem.org/benefits</span></span></a><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">. </span></span></span></span></p>\n\n<p> </p>\n\n<p><span style=\"font-size:11pt;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#1f3864;\">Bonus Eligibility:  </span></span></span></strong><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\">Available to qualifying full or flex time employees. Eligibility will be determined upon offer.<strong> </strong></span></span></span></span></p>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">Memorial Health System is an equal opportunity provider and employer.</span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"color:#000000;\">If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at </span><a href=\"https://www.ocio.usda.gov/document/ad-3027\" target=\"_blank\" rel=\"noreferrer noopener\">https://www.ocio.usda.gov/document/ad-3027</a><span style=\"color:#000000;\">, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, S.W., Stop 9410, Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at </span><a href=\"mailto:[email protected]\">[email protected]</a><span style=\"color:#000000;\">.</span></span></span></p>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"background-color:#ffffff;\"><span style=\"color:#1f3864;\">* </span></span><strong><span style=\"background-color:#ffffff;\"><span style=\"color:#1f3864;\">Memorial Health System is a federal drug-free workplace.  This policy prohibits marijuana use by employees. </span></span></strong></span></span></p>",
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