Perform denial analysis and database management to mitigate claim denials, maintain data integrity across denial and financial systems, run analyses, support related administrative tasks, and provide customer service to reduce denial rates.
Job Summary
Performs the daily functions of denial analysis, which includes database management, follow-up, administrative support, and customer service to achieve improved mitigation of denials, reduced denial rates and excellent customer service. Performs other duties as assigned.
Responsibilities
- Creates and performs analysis of denial and financial data.
- Demonstrates an ability to evaluate and maintain the proper level of data integrity within the denial mitigation database(s), including any applicable financial information systems.
- Demonstrates proficiency with any applicable System financial information systems required to perform job
- Completes assigned goals.
Specifications
Experience
- Experience working in healthcare (hospital or physician setting) or in a payer environment performing activies such as data entry, denials, billing, collections, registration and/or scheduling.
Minimum Required
- 2 - 4 years experience in healthcare (hospital or physician setting) or 2-4 years in a payer environment performing activies such as data entry, billing, collections, registration and/or scheduling.
Preferred/Desired
- 5 years in healthcare billing, collection, customer service, cash posting, and administrative support experience with a multi hospital system.
Education
- High School Diploma required RHIT or LPN preferred 2 yrs college preferred Computer literacy and medical terminology required.
Minimum Required
- Skill in communicating clearly and effectively using standard English in written, oral and verbal format to achieve high productivity and efficiency. Skill to write legibly and record information accurately as necessary to perform job duties.
Preferred/Desired
- 2 yrs college preferred but not required.
Training
Minimum Required
- Strong organizational, analytical and problem solving skills with ability to understand and troubleshoot interconnected data and denial processes.
Preferred/Desired
Special Skills
- Familiarity with electronic medical records and cliams/practice management systems.
Minimum Required
- Working knowledge of Excel 2007 and Microsoft Office products. Comfort with data entry within Revenue Cycle software, patient management systems, and Windows based applications preferred.
Preferred/Desired
- Expert Knowledge of Excel 2007 and Microsoft Office products, including proficiency in data set filtering, sorting and grouping using Microsoft Excel and/or access database.
Licensure
Minimum Required
Preferred/Desired
- LPN;RHIT
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