Denial Management Coordinator

As a Denial Management Coordinator at Memphis Professional Building, you will be responsible for managing denial activities effectively. This includes overseeing denial management action projects, developing systems to track and trend root causes of denials, and collaborating with leadership and staff on process improvement initiatives. Your goal will be to minimize new denials and enhance overall operational efficiency, thereby positively impacting patient care.

The ideal candidate for the Denial Management Coordinator position at Memphis Professional Building should possess a High School Diploma or equivalent. A technical degree or diploma in Medical Billing and Coding is also required. Additionally, having 5-7 years of experience in revenue cycle management is essential, along with preferred certifications such as a Certified Coding Specialist or a Certified Professional Coder.

Strong organizational and communication skills are crucial for a Denial Management Coordinator at Memphis Professional Building. You will need to effectively communicate with physicians, managers, and staff while maintaining compliance and quality standards. These skills will enable you to facilitate teamwork and drive successful outcomes in denial management and process improvements.

The work environment for the Denial Management Coordinator at Memphis Professional Building is office-based, typically requiring close visual acuity for tasks related to data analysis, computer use, and extensive reading. The associate may face light physical demands and is not generally exposed to adverse environmental conditions, making it a supportive and collaborative space to thrive.

At Memphis Professional Building, we prioritize a culture centered on family values, teamwork, and community impact. As a Denial Management Coordinator, you’ll be part of a workplace that embraces the Power of One, encouraging collaboration and commitment to high standards of care while fostering continuous personal and professional growth.

In navigating difficult conversations about denials, I focus on clear, respectful communication, emphasizing the goal of collaborative problem-solving. It's important to approach the situation with empathy, listen actively, and provide constructive feedback that fosters a culture of learning rather than blame.

Certainly! I have over five years of experience in revenue cycle management, specifically focusing on denial management and appeals processes. My role has involved examining denial trends, collaborating with teams to implement process improvements, and educating staff on coding compliance to ensure timely reimbursement.

To track the root cause of denials, I implement a structured system for data collection and analysis. I categorize denials by type and source, utilize reporting tools to identify patterns, and collaboratively discuss with team members to address underlying issues, enabling proactive solutions that mitigate future denials.

I once led a project where we analyzed denial data and discovered a high frequency of denials related to coding errors. By collaborating with coding staff for targeted training sessions, we resulted in a significant decrease in this type of denial over three months, enhancing our overall efficiency in claims processing.

To ensure compliance, I stay updated on the latest industry regulations and policies by attending relevant training and reading publications. Additionally, I conduct regular audits of denial management processes and implement checks in our systems to adhere to best practices and reduce compliance risks.

I utilize a combination of one-on-one training sessions, group workshops, and informative materials like newsletters or bulletins. My focus is on interactive learning, encouraging questions and discussions, and providing real-world examples to help staff understand the importance of accurate documentation and coding to minimize denials.

I utilize a systematic approach by assessing urgency and importance. I prioritize tasks based on deadlines and their potential impact on our revenue cycle. Regularly reviewing pending denials helps me stay organized and ensures that I address the most critical matters promptly.

I have experience in various software systems, including electronic health record (EHR) systems and revenue cycle management tools. Proficiency in analytics software also helps me track denial patterns and generate reports that inform our strategic approaches to denial reduction.

I remain motivated by focusing on the positive impact my work has on patient care and the overall efficiency of the healthcare facility. I set personal goals for continuous improvement and celebrate team achievements, recognizing that each resolved denial contributes to our mission of serving the community.

I recall a particularly challenging case where a high dollar amount was denied due to lack of documentation. After careful analysis, I coordinated with the clinical team to gather the necessary paperwork and successfully appealed the denial by providing ample evidence, ultimately ensuring reimbursement for the services rendered.