Denial Management Coordinator

🕒 June 12

🗽 New York – Remote

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💵 $19 - $24 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

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Logo of Rochester Regional Health

Rochester Regional Health

10,000+ employees

⚕️ Healthcare Insurance

📚 Education

🤝 Non-profit

Healthcare Insurance • Education • Non-profit

Rochester Regional Health is an integrated health services organization serving the people of Western New York. It operates multiple hospitals and healthcare facilities, providing a wide range of healthcare services, including emergency care, primary care, specialty clinics, and urgent care. The organization is committed to medical education and research, offering training programs, residencies, and clinical trials. Rochester Regional Health focuses on comprehensive care with emphasis on treating patients respectfully and meeting their diverse medical needs across all stages of life.

📋 Description

• Oversee the coordination and tracking of the healthcare responses to denial inquiries • Prioritize review of claims by evaluating due dates and their impact • Receive, log, and track all denial activity and correspondence • Maintain an accurate database of all denial activity • Develop and maintain clear communication channels with internal insurance reviewers • Utilize aggregate denial activity data to support policy improvements • Work closely with the Physician Advisor team to escalate issues and educate providers • Identify common and overlapping issues and alert leadership • Develop and prepare various reports for leadership • Coordinate ad hoc meetings on immediate denial activity • Provide updates on process changes and denial regulations

🎯 Requirements

• AAS or two or more years of relevant work experience within the healthcare revenue cycle • Current certification as an RHIA, RHIT, RN, CCS, or CCS-P, preferred • Experience working with coding, revenue cycle, and utilization management, preferred • Knowledge of medical necessity, coding and documentation guidelines for Medicare, Medicaid and other third party payers, preferred • Experience with Epic EHR, preferred • Experience in preparing and presenting educational material to staff and providers, preferred

🏖️ Benefits

• Health insurance • Flexible work arrangements • Professional development opportunities

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