Denials Rep Req #: 30110620 Category: Business Ops Facility: Beaumont Services Center Department: BBS Appeals Management Schedule: Full time Shift: DaysHours: 7:00a-3:30Pm Job Details:
Job Summary:
The Denials Analyst will be responsible for reviewing, researching and taking the next step based on the type of denial and protocol for the denial type. The Denials Analyst will provide a detailed monthly denial summary for each Beaumont Health facility.
Job Responsibilities:
Understanding of the revenue cycle and the responsibility and goals of each area and how they impact the revenue cycle
Review all accounts that have has a payer denial based on the Denial Management Policy and Procedure and take appropriate action based on the type of denial.
Understanding of current payer contracts
Apply corrections to patient demographics, charges, adjustments and payments
Identify and provide communication and education on trends identified on the monthly Denial Log
Appeal denials based on the appeal criteria found within the Denial Management policy
Work with facility departs when necessary for resolution or appeal of denials related to that department (i.e Lab, Patient Access, Case Management)
Prepare and distribute a monthly denial log by facility to include account number, payor type, reason for denial
Identifies and communicates monthly denial trends and provides education as necessary to avoid recurring denials for the same denial reason code
Document all findings and action taken in the Patient Accounting System following policy and procedure for documentation requirements.
oMaintains a professional image and provides excellent customer service
oAttends department meetings and education sessions
oMeets/exceeds performance expectations within required timeframes.
oPractices and adheres to the "Code of Conduct" philosophy and Mission and Values statement.
oSupports special projects as requested.
oAdheres to all Beaumont Health Policies and Procedures
oPerforms other duties as assigned.
Education:
High School Diploma
Licensure/Certification/ Registration:
HFMA CRCR certification within 6 months.
Preferred Work Experience:
Relative work experience in a health care based setting preferred.
Knowledge of Revenue cycle structure and process.
Must be detail oriented.
Strong verbal and written communication skills.
Proficiency in Excel, Word, PowerPoint and Access is necessary.
Beaumont Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, , gender identity, orientation, age, status as a protected veteran, or status as a qualified individual with a disability.
