Denials and Appeals Specialist II

The Denials Coordinator is a reimbursement specialist/payment recovery specialist position. The Coordinator is responsible for identifying underpayments, specifically denials or reductions, and working with the payers to recover the reimbursement. This will include working with the hospital’s billing system and audit software as well as the hospital’s managed care contracts. The Coordinator also must work with various departments within the organization, such as ancillary departments and the coding and billing department to troubleshoot and identify root cause variances in order to prevent future losses in reimbursement. These variances should be communicated via daily interaction and monthly status meetings with department manager.

The qualified candidate will possess the following:

A. Education:

1. High school diploma or GED from an accredited institute is required. Associate’s degree or some college coursework from an accredited college or university preferred.

B. Experience:

1. Two years of experience in healthcare billing, coding, collections, payment processing, or denials management. Denials management experience preferred.

C. Licensure/Certifications:

1. Professional Certifications related to Coding, Billing, Accounting, Patient Representative, or other related field preferred.