Overview:
As a part of Documentation Integrity, the Denials team is comprised of highly specialized analysts who ensure Norman Regional Health System follows a compliant review process to perform audit and appeal of denials.
Responsibilities:
Responsible for coordinating and analyzing denials including government audits, and pre and post payment audits.
Responsible for coordinating government audit processing, responses and assignments to appeal registered nurses on denial team.
Responsible for accurate reporting and accounting of government audit activity and outcomes to reflect the financial impact.
Qualifications:
Education
High School diploma or equivalent.
Completion of Medical Terminology Course.
Prefer post high school education in related field such as Accounting and/or Business Communications.
Excel/MS Word skills in word processing and spreadsheets creation and maintenance required.
Knowledge of Medicare/Medicaid and third party billing regulations.
Experience
Seven years previous hospital Patient Accounting office experience with experience in hospital Medicare/Medicaid/third party billing and collections preferred
Three years of experience in Medicare, Medicaid, third-party billing, and compliance and reimbursement regulations required.
Preferred: a minimum of seven years experience in medical auditing, hospital Patient Accounting office experience, Minimum of 3 years experience in hospital Medicare/Medicaid/third party billing and collections, Minimum of 3 years experience with charge auditing, CPT/HCPC and Revenue coding review.
Experience in reporting in Excel, Word and data entry.
Experience in navigating Electronic Health Records.
(Above requirements can be met by equivalent combination of education and experience)
Licensure/Certification
Advanced coding certification (Certified Coding Specialists (CCS - Issued by American Health Information Mgmt Assoc - AHIMA, CPC, CPC-H, RHIT, or RHIA) preferred.
Compensation/Benefits
$18.
80-$30.
71/hr depending on previous work experience.
Benefits include medical, dental, vision, short-term disability, long-term disability, life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship opportunities, retirement plans, free parking, and opportunities for advancement.
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