In an environment of continuous quality improvement, the Denials Management Coordinator is responsible for reviewing all denials to determine patterns in errors, payors, and internal processes to improve our denial rate. Exhibits the MHS Standards of Excellence and exercises strict confidentiality at all times.

 

Job Functions:

Analyzes all denials for patterns. Works with front line staff and educate on proper processes. Ability to verbalize to insurance carriers and write appeal details to support additional payment on denied claims. Accurately and consistently documents the results of all denial reviews in the hospital information system. Prepares reports as required by management regarding audit results, process improvement recommendations and systemic payment errors. Makes monthly observations and recommendations to prevent future denials. Assumes all other duties and responsibilities as necessary.