Job details

Denials Coordinator - job 1 of 2

Overview:

ONE TEAM. ALL HEART. At Oklahoma Heart Hospital (OHH), patient care is at the heart of everything we do. This physician owned hospital was designed by cardiologists to ensure that patients receive expert, individualized care with utmost comfort. OHH offers a competitive benefits program to all team members from the first day of employment.

Top Tier Benefit Packages:

Medical, Dental, and Vision
401 (k) plan
Paid Time Off (PTO)
Extended Medical Benefit (EMB)

OHH Financial Services: 7800 NW 85th Terrace, OKC OK 73132

Full-Time Days

Responsibilities:

The 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 Denials Coordinator will assist with first and second level appeals under the Denials and Appeals RN’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 and Appeals RN to prepare appeals on clinical denials.
Submits Notices of Admission for any missing inpatient admission to insurance companies.
Requests inpatient authorizations on any admissions that did not receive authorization while the patient was in-house.
Submits appeals for any medical necessity or inpatient denial, as well as second-level appeal for any type of denial.
Acts as a subject matter expert for other business office staff to help reduce high dollar and high impact denials.
Reviews readmissions and outpatient visits within 72 hours of an inpatient stay, working under an RN’s guidance for medical appropriateness of combined billing.
Appeals professional denials related to a hospital service.
Follows up on receipt of payment for any appeal submitted.

Qualifications:

Education: High school graduate or equivalent preferred.

Experience: Minimum of two (2) years in Insurance Follow-Up or Denials. Clinical Denials experience is preferred; Epic experience is a plus but not required.

Working Knowledge: Insurance collections and denials, with an emphasis on inpatient workflows is preferred.

Essential Cognitive Abilities: Requires strong communication and organizational skills. Must demonstrate independent judgment and sound reasoning ability. Ability to maintain concentration and organization while dealing with multiple issues and frequent interruptions.

Interpersonal Skills: Ability to interact with other departments, physicians, hospital and practice leadership, and peers to enact proactive charge capture practices. Must be able to communicate technical and legal details to all parties involved, and provide education on focus areas.

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.

Learn more about diversity at Oklahoma Heart Hospital.

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