Northern Arizona Healthcare

Improving health, healing people.

Denials Administrative Specialist

Full TimeRemoteTeam 1,001-5,000Since 1936H1B SponsorCompany SiteLinkedIn

Location

Alabama + 14 moreAll locations: Alabama, Arizona, Florida, Idaho, Kansas, North Carolina, Ohio, Oklahoma, Michigan, Missouri, Pennsylvania, South Carolina, Tennessee, Texas, Virginia

Posted

23 days ago

Salary

Not specified

High SchoolEnglish

Job Description

• Review and compile required denials documentation and submit in a timely manner to ensure payment. • Track and document tasks in Midas to assist Nurse Denials Specialist in preparing and following up on cases. • Assist in preparing documentation for appeal letters. • Track and monitor concurrent and retrospective cases on denials spreadsheets. • Assist in auditing for concurrent reviews, admission status, coding, DRG, and outpatient denials management. • Assist in gathering data for performance of retrospective denials. • Gather data and documentation to assist the Nurse Denials Specialist and the Physician Advisor in review of clinical denials. • Request necessary documentation from physician's offices for denials cases. • Assist with paperwork and follow up of self-denials cases, Code 44s, and Noridian appeal cases. • Track and monitor audits of clinical information from payers, governmental agencies, etc. • Provide outreach and assistance to other support staff within the department when absent or in need of additional support of their work. • Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner. • Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility. • If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.

Job Requirements

  • High School Diploma or GED- Required
  • Associate's Degree or some college education- Preferred
  • Previous experience in denials management or relatable experience- Preferred

Benefits

  • Telecommute
  • Health insurance
  • Paid time off

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