Denials Coordinator Analyst

Denials Coordinator Analyst

Who we are:

At Lifepoint Health, we provide quality healthcare to rural communities. As a valued member of our team, you will be an integral part of a group working together to elevate Lifepoint's healthcare delivery network. Our network includes 60+ community hospitals, 60+ rehabilitation/behavioral health hospitals, and 250 additional sites of care across the United States. As an organization, we are dedicated to serving communities nationwide by providing exceptional care. We believe in the power of our talented teams and strive to create environments where employees find purpose and fulfillment.

What you’ll do:

As a Denials Coordinator Analystyou are responsible for reviewing patient accounts and ensuring they are in the routed correctly within the revenue cycle software. Working with appeals specialists to resolve outstanding denials in a timely manner and tracking outcomes of appeals. Track, trend and analyze data to determine root cause of denials and assist with updating appropriate departments and leadership of identified opportunities. and resolving coding-related edits. Ensure compliance with official guidelines (ICD-10-CM, AHA Coding Clinic, AMA CPT Assistant and Guidelines), AHIMA Standards of Ethical Coding, and Lifepoint Health Support Center (HSC) policies and procedures.

Responsibilities:

• Work with Appeals Specialists to obtain appeal decision, documentation to support appeal, and submission of appeals to payer auditors within specified timeframe.
• Review accounts to determine if they have necessary documentation from payer auditors and have been routed correctly to the work queue.
• Monitor the status of appeals and follow up on outcomes of appealed claims for tracking.
• Maintain tracking information for reporting purposes and prepare routine reports.
• Analyze denial trends and patterns to identify root causes.
• Generate and maintain reports on denial rates, appeal success rates, and other relevant metrics.
• Provide regular updates to management.
• Identify opportunities for process improvement and efficiency in the denial management process.
• Seek advice and guidance as needed to ensure proper understanding.
• Assist others with responsibilities and adjusts work schedule to meet department needs.
• Use independent discretion/decision-making while effectively working remotely.
• Attend required educational webinars and conference calls.
• Complete all assigned compliance courses within the designated period.
• Conform to AHIMA’s Code of Ethics and Standards of Ethical Coding, LifePoint Attendance Policy, and ensure patient/employee privacy and dignity by maintaining confidentiality with no infractions.
• Other related job tasks or responsibilities as assigned.

Qualifications - External

What you’ll need:

Education: HS Diploma required. Associate degree in health-related field preferred.

Experience: Three (3) yrs. experience reviewing inpatient denied accounts in acute care hospital setting required

Certifications: Certified Coding Specialist (CCS) preferred.

Why choose us:

As a team member of the Health Support Center, our goal is to support those that are in our facilities who are interfacing and providing care to our patients and community members. Our focus is to attract, retain, and empower a diverse and determined workforce. Our mission statement is at the heart of who we are and what we do: “Making Communities Healthier.” In this shared mission, we believe that our collective efforts will shape a healthier future for the communities we serve.

Benefits: We offer an excellent total compensation package, including a competitive salary and benefits. Some of our benefits include 401k, flexible PTO, generous Employee illness benefit (EIB), medical, dental, vision, tuition reimbursement, and an Employee Assistance Program. We believe that happy, healthy people have a passionate engagement with life and work and have designed our package to enhance your wellbeing.

Job Type: Full-time

Pay: $26.00 - $31.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• Remote

Work Location: Remote