Arkansas Heart Hospital
Denials Management Coordinator- FT
Arkansas Heart Hospital, Little Rock, Arkansas, United States, 72208
Job Details
Job LocationArkansas Heart Hospital - Little Rock, AR
Position TypeFull Time
Description
Position Summary
This position is primarily responsible for documenting, categorizing, trending, and providing a root cause analysis of denials and underpayments received by payors. Works collaboratively with key team members to initiate appeals process and follow up on receipt and outcome of appeals. Also responsible for assisting with the development of the denial management team action plans, taking corrective action to receive proper payment for services rendered, and reporting and summarizing findings and outcomes in a timely manner. Works collaboratively with other departments to seek proper reimbursement for those services rendered. This person requires excellent interpersonal skills and the ability to work with minimal supervision.
Work Schedule
Monday through Friday regular business hours, or as special assignments dictate.
Qualifications/SpecificationsEducation:
High school degree or equivalent.Licensure/Certification:
None required.Experience:
Minimum two years financial experience required. Hospital and/or medical office experience preferred.Essential Technical/Motor Skills:
Must be able to perform computer tasks at a user's level. Must be proficient in use of calculators, printers, copiers, etc. Proficient in Hospital Patient Accounting Systems.Interpersonal Skills:
Must be able to interact and communicate with all levels of staff, physicians, patients, and families in an effective manner, exhibiting tact, enthusiasm, and patience. Must be able to be sensitive to cultural and bilingual issues. Ability to work individually and in a team setting.Essential Physical Requirements:
Requires sitting and standing associated with a normal office environment, including sitting at a computer for long periods of time. Requires full range of body motion including handling and lifting, manual and finger dexterity, and eye-hand coordination.Essential Cognitive Abilities:
Requires good communication and organizational skills. Requires reasoning ability and good independent judgment. Requires working under stressful conditions and irregular hours. Requires working with frequent interruptions. Able to comprehend and interpret complex clinical subject matter related to specialty. Able to interpret and communicate policies and procedures to all levels of staff effectively.Essential Sensory Requirements:
Essential skills including the ability to listen, and the ability to read and interpret information quickly, in wiring, tabular, or graphic form. Able to respond to patient needs by interpreting facial expressions, and/or verbal communications.Exposure to Hazards:
This position is not constantly exposed to airborne or blood borne pathogens or radiological or chemical hazards, other than those recognized in the MSDS as common to a business office setting.Other:
Understands the mission and vision of the hospital. Operates within the concept of patient focused care. Evolves into an effective team member. Must adhere to dress code; good grooming and personal hygiene habits; and strict adherence to attendance policies. Maintains knowledge of and conforms to hospital policies and procedures.
Primary DutiesIdentify and accumulate denied claims.Document denial and payment related data into the hospital's denial management system.Analyze and document the root cause of denials and underpayments.Coordinate with Revenue Cycle team in resolving denials and underpayments.Appeal claims as appropriate and filter other claims to the appropriate hospital staff members for claim resolution.Update patient account record to identify actions taken on the account.Serve as liaison with third-party payers/agencies regarding appeals to ensure optimal reimbursement and any other billing/payment issues or questions are resolved.Continuously monitor denied claims throughout the denials management process to ensure claim resolution is achieved.Ensure adjustment requests are prepared correctly and submitted in a timely manner for denied claims that need to be written off.Work closely with Revenue Cycle team and other hospital departments to assist with identification of root cause of denials and development of process improvements to significantly reduce denials.Serve as an educational resource for hospital staff to reduce or eliminate denials.Prepare accurate statistical and other reports as directed.Summarize and report findings and outcomes in a timely manner.Assist in developing recommendations to maintain efficient and effective denial management processes.Perform other duties as directed to provide the most efficient service to the hospital/clinic in a manner which supports the overall effectiveness for the department and the hospital/clinic.
Job LocationArkansas Heart Hospital - Little Rock, AR
Position TypeFull Time
Description
Position Summary
This position is primarily responsible for documenting, categorizing, trending, and providing a root cause analysis of denials and underpayments received by payors. Works collaboratively with key team members to initiate appeals process and follow up on receipt and outcome of appeals. Also responsible for assisting with the development of the denial management team action plans, taking corrective action to receive proper payment for services rendered, and reporting and summarizing findings and outcomes in a timely manner. Works collaboratively with other departments to seek proper reimbursement for those services rendered. This person requires excellent interpersonal skills and the ability to work with minimal supervision.
Work Schedule
Monday through Friday regular business hours, or as special assignments dictate.
Qualifications/SpecificationsEducation:
High school degree or equivalent.Licensure/Certification:
None required.Experience:
Minimum two years financial experience required. Hospital and/or medical office experience preferred.Essential Technical/Motor Skills:
Must be able to perform computer tasks at a user's level. Must be proficient in use of calculators, printers, copiers, etc. Proficient in Hospital Patient Accounting Systems.Interpersonal Skills:
Must be able to interact and communicate with all levels of staff, physicians, patients, and families in an effective manner, exhibiting tact, enthusiasm, and patience. Must be able to be sensitive to cultural and bilingual issues. Ability to work individually and in a team setting.Essential Physical Requirements:
Requires sitting and standing associated with a normal office environment, including sitting at a computer for long periods of time. Requires full range of body motion including handling and lifting, manual and finger dexterity, and eye-hand coordination.Essential Cognitive Abilities:
Requires good communication and organizational skills. Requires reasoning ability and good independent judgment. Requires working under stressful conditions and irregular hours. Requires working with frequent interruptions. Able to comprehend and interpret complex clinical subject matter related to specialty. Able to interpret and communicate policies and procedures to all levels of staff effectively.Essential Sensory Requirements:
Essential skills including the ability to listen, and the ability to read and interpret information quickly, in wiring, tabular, or graphic form. Able to respond to patient needs by interpreting facial expressions, and/or verbal communications.Exposure to Hazards:
This position is not constantly exposed to airborne or blood borne pathogens or radiological or chemical hazards, other than those recognized in the MSDS as common to a business office setting.Other:
Understands the mission and vision of the hospital. Operates within the concept of patient focused care. Evolves into an effective team member. Must adhere to dress code; good grooming and personal hygiene habits; and strict adherence to attendance policies. Maintains knowledge of and conforms to hospital policies and procedures.
Primary DutiesIdentify and accumulate denied claims.Document denial and payment related data into the hospital's denial management system.Analyze and document the root cause of denials and underpayments.Coordinate with Revenue Cycle team in resolving denials and underpayments.Appeal claims as appropriate and filter other claims to the appropriate hospital staff members for claim resolution.Update patient account record to identify actions taken on the account.Serve as liaison with third-party payers/agencies regarding appeals to ensure optimal reimbursement and any other billing/payment issues or questions are resolved.Continuously monitor denied claims throughout the denials management process to ensure claim resolution is achieved.Ensure adjustment requests are prepared correctly and submitted in a timely manner for denied claims that need to be written off.Work closely with Revenue Cycle team and other hospital departments to assist with identification of root cause of denials and development of process improvements to significantly reduce denials.Serve as an educational resource for hospital staff to reduce or eliminate denials.Prepare accurate statistical and other reports as directed.Summarize and report findings and outcomes in a timely manner.Assist in developing recommendations to maintain efficient and effective denial management processes.Perform other duties as directed to provide the most efficient service to the hospital/clinic in a manner which supports the overall effectiveness for the department and the hospital/clinic.