Oklahoma Heart Hospital looking for Denials Specialist with Coding Certification

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Yukon, OK
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The Oklahoma Heart Hospital is looking for Denials Specialist with Coding Certification (CPC or CCS). Apply at www.okheart.com

Denial Specialist

Requisition ID 2017-2128
Location US-OK-Oklahoma City


Entity Oklahoma Heart Hospital, Business Office/Financial Services
Department Business Office

Shift 1st
Category Business Office

Position Type Regular Full-Time Days

More information about this job:

Overview:

This position is located at our Hartford Building, not at Hospital.

Responsibilities:
The Denials Specialist is responsible for generating and reviewing payment discrepancy reports on an ongoing basis for all Medicare and Managed Care contracts. The Denials Specialist will be responsible for generating appeal letters to send the payer to dispute the denial or underpayment identified. Responsible to perform follow up on an ongoing basis for the encounters that have not reached resolution. Uses own judgment and initiative in detecting and resolving payment disputes with insurance companies. Responsible for arranging and facilitating monthly payer meetings in an effort to reach resolution to outstanding disputes. Tracks current as well as resolved activity in an effort to trend denial activity being seen by the facilities for reporting purposes. Performs all work with accord to the mission, vision and values of Oklahoma Heart Hospital.


Qualifications:
Education: : High school diploma or equivalent required. Associate degree and/or degree school program preferred. Minimum three (3) years progressive experience in healthcare financial setting may be substituted for degree.


Experience: Minimum of three (3) years of hospital based nursing practice with experience in utilization/case management a plus. Knowledge of HIPAA, Medicare and Medicaid compliance regulations in acute care setting, third party payer’s process preferred. Must have the ability to effectively use computer systems for gathering, reporting and analysis of clinical data. Excellent organizational and communication skills required. Certified Coding Specialist CCS or willing to obtain CCS preferred but not required.
 
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