Denial Coordinator / Billing - PMC Medical

Denial Billing Coordinator

Location: Owosso, MI – Remote Possible

Salary: 75k - 95k (depending on experience/may vary)

Length: Long-Term, Full-Time

At PMC Med Staff, we partner with reputable healthcare facilities and providers to fill crucial roles in various specialties. Our commitment to both our clients and candidates ensures a seamless and mutually beneficial placement process. We understand the demands of the healthcare profession and are dedicated to finding positions that align with your career goals and preferences.

RESPONSIBILITIES:

• Minimum of 3 years’ experience working in a professional environment
• Minimum of 3 years’ experience working in Denial Management within a facility or professional practice.
• PC experience required
• Use of multi-line phone experience required
• Office Procedures required.
• Customer Service experience required
• Previous experience as a manager, team lead or trainer – required
• Open, honest, and tactful communication skills

• Applies excellent customer service skill.
• Always maintains confidentiality of all information.
• Maintains operating instructions and keeps staff updated and educated.
• Completes work within authorized time to assure compliance.
• Daily work denied claims identified in Expanse through Denial Management or by denials identified through 835 payment files in Quadax or other available programs or reports.
• Critical thinking with the ability to validate the accuracy of the denial in accordance with insurance contracts and billing policies.
• Demonstrates the ability to determine correctness of charges and coding.
• Secure needed medical record documentation required by or requested by insurance companies when necessary to submit with claims.
• Work with, when necessary, the Authorization/Benefits/Verification specialists Team to obtain proper authorizations for services
• Report denial trends identified to Revenue Integrity, Patient Financial Services Manager and Revenue Cycle Director.
• Work closely with Revenue Integrity Department in identifying payment issues based on contracts
• Effectively disburse information to Patient Financial Services Manager and Director of Revenue Cycle to enable education around denials and solutions to reduce the number of denials.
• Work with other departments regarding coding or charge issues related to claims.
• Attend or participate in webinars/seminars concerning billing and reimbursement changes.
• Work with patients when needed to obtain resolution of accounts.
• Must be able to work effectively with others and complete tasks within specified or given deadlines.
• Demonstrates knowledge of and supports hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality statements, corporate compliance plan, customer service standards, and the code of ethical behavior.

EDUCATION

• Associate degree preferred.
• High school diploma or equivalent is required.
• Post high school courses in medical billing, medical terminology is preferred,