Professional Denials Coordinator

Overview

ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients' journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we're shaping the future of heart care in Oklahoma by serving the state and leading the nation.

We can't wait for you to join our heart-centered team!

• Comprehensive Benefits:
  • Medical, Dental, and Vision coverage
  • 401(k) plan with employer match
  • Long-term and short-term disability
  • Employee Assistance Programs (EAP)
  • Paid Time Off (PTO)
  • Extended Medical Benefits (EMB)
  • Opportunities for continuing education and professional growth

The Professional 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 Professional Denials Coordinator will assist with first and second level appeals under the Denials Manager'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 RN to prepare appeals on denials.
• Defend and appeal claims, including researching root cause, collecting required information, adjusting the account as necessary, resubmitting claims and all appropriate follow up activities.
• Submits requests to clarify clinical documentation for accurate coding of denials.
• Works with Denials Analyst and Underpayments Coordinator to call attention to areas of opportunity or system/process errors.

• Education: High school graduate or equivalent preferred.
• Experience: Minimum of two (2) years in professional/clinic Insurance Follow-Up or Denials. Clinical Denials experience is preferred;
  Epic experience is a plus but not required. CPC is strongly encouraged.
• Working Knowledge: Insurance collections and denials, with an emphasis on professional coding is preferred.