Complete monthly denial logs in required timeframe
Attend monthly denial meetings with facilities as assigned
Communicate with all necessary departments to identify and resolve denial trends and issues
Review and analyze all denial trends and issues as assigned
Maintain working knowledge of all payer guidelines and requirements as they relate to denials and appeals.
Monitor and work all denials and appeals as assigned
Properly track and document all denial and appeal activity.
Maintain all logs, account notes and system records as assigned
Review outpatient RAC denials and appeal as needed
Monitor AB rebills that needed on RAC accounts and post recovery or denial adjustments as needed
Monitor assigned duties in C360, and ensure proper handling of all RAC accounts
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed
below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Required Education And Experience
High school diploma or equivalent
Minimum of one year experience in a healthcare setting
Preferred
Working knowledge of the revenue cycle
Required Knowledge/Abilities
Working knowledge of denials and appeal processes including a basic understanding of contracts and payer policies
Working knowledge of current medical terminology
Ability to communicate effectively both verbal and written
Ability to work independently and to meet deadlines
Required Computer Skills
Working knowledge of Outlook, Microsoft Word and Excel or equivalent
INDSS
Seniority level
Entry level
Employment type
Full-time
Job function
Other
Industries
Hospitals and Health Care
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