Denials Prevention Coordinator

Maintains a professional image and exhibits excellent customer relations to patients, visitors, physicians, and co-workers in accordance with our Service Excellence Standards and Core Values.

Provide operational expertise, direction, and input to other departments as it relates to denials issues.

Serves as primary liaison between Managed Care and Payor Relations and other organizational departments to provide information regarding denial trends and projects that can be implemented on the local campuses to reduce denials.

Analyzes denial trends for organizational education purposes

Research online medical bulletins, policies, and authorization requirements for payers.

Participate and lead Denials Prevention meetings with other organizational stakeholders

Create and report all data requested for Denials reporting utilizing various software packages.

Skills in planning, leading, facilitating, and implementing improvement projects/teams.

Performs other duties as assigned by Director.

Work Schedule: 80 Hours bi-weekly

Experience with data manipulation, word processing, spreadsheets, and data analysis to report trends/patterns/statuses. Must be proficient with Microsoft Excel, Work, and PowerPoint.

Working knowledge of managed care terminology, managed care reimbursement methodologies, and billing/coding terminology (i.e ICD-10, CPT, Revenue Codes) preferred.

Complete working knowledge of all aspects of the revenue cycle

Excellent interpersonal, written and organizational skills required.

Experience in a progressive healthcare environment with responsibilities for data analysis preferred. Attention to detail and accuracy skills required.

Report writing experience preferred.

Must be flexible, able to work independently and able to achieve deadlines and deliverables with minimal supervision.

Experience with problem solving techniques.

Licenses/Certifications/Registrations/Education:

Bachelor Degree in Business or Healthcare with 3 years of experience in healthcare revenue cycle preferred. Associates Degree with 6 years of experience in healthcare revenue cycle or High School Diploma with 10 years of experience in healthcare revenue cycle required or any equivalent combination of education and experience that provides the knowledge & skill required to perform the job duties.

Founded in 1906, McLeod Health is a locally owned and managed, not for profit organization supported by the strength of more than 900 members on its medical staff and more than 2,900 licensed nurses. McLeod Health is also composed of approximately 15,000 team members and more than 90 physician practices throughout its 18-county service area.

With seven hospitals, McLeod Health operates three Health and Fitness Centers, a Sports Medicine and Outpatient Rehabilitation Center, Hospice and Home Health Services. The system currently has 988 licensed beds, including Hospice and Behavioral Health. The hospitals within McLeod Health include: McLeod Regional Medical Center, McLeod Health Dillon, McLeod Health Loris, McLeod Health Seacoast, McLeod Health Cheraw, McLeod Health Clarendon and McLeod Behavioral Health.

If you would enjoy working in a dynamic environment and are looking for an opportunity to become part of a stellar team of professionals, we invite you to apply online today. We are an equal opportunity employer.