Denials Coordinator in Nashville, TN at Parallon

Date Posted: 3/7/2018

Job Snapshot

  • Employee Type:
  • Location:
    552 Metroplex Drive
    Nashville, TN
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:

Job Description

Job Summary – The Denial Coordinator will oversee and drive the Denial Management Action Team Project and
identify areas for continued process improvements that will further decrease new denials, final write off denials, and
prebill denials. Work with SSC leadership, Division Leadership and others on process improvement opportunities.
Supervisor – Denials Director
Supervises – N/A
Functional areas:
 Oversee and drive Denial Management Action Team Project
 Tracks and trends root cause for all denials
 Ensures action plan development and execution of plan
 Assist in the development of financial data collection and measurement tools

Knowledge, Skills & Abilities
 Leadership – guides individuals and groups toward desired outcomes, setting high performance standards and
delivering leading quality services
 Customer Orientation – establishes and maintains long term customer relationships, building trust and respect by
consistently meeting and exceeding expectations
 Communication - communicates professionally, clearly and concisely
 Tactical Execution – oversees the development, deployment and direction of complex programs and processes
 PC Skills – demonstrates advanced proficiency in Microsoft Office applications and others data mining software
 Organization - proactively prioritizes needs and effectively manages customer request
 Project management – ability to identify, organize and communicate project goals, schedules, responsibilities,
progress and performance
 Teambuilding - demonstrates ability to foster and perform in a team-building environment
 Financial management – ability to identify operational processes to reduce denials and streamline process
 Understands basic payer rules which affect reimbursement and/or compliance requirements
 Understands case management operations and workflow as it relates to the communication and authorization
process with all Payors (except Medicare).
 Familiarity with major components of Revenue Cycle; including patient registration, coding, charging, managed
care, etc.
 Policies & Procedures - articulates knowledge and understanding of organizational policies, procedures and
 Detail oriented and able to work with minimal supervision

Job Requirements

Duties (included but not limited to):
 Oversee and drive the Denial Management Action Team Project
 Schedule denial calls with facilities to include; Hospital CFO, Hospital Case Management, Patient Access Director,
SSC CFO, SSC Denial Director, Hospital Compliance Director, Division Case Management Director, and Division
Denial Director
 Prepare and send denial report to facility for review prior to the denials calls
 Assist in the development of financial data collection and measurement tools
 Develop and provide monthly denial reports and submits to Division and Facility Leadership
 Identify denial trends to be discussed during the denial calls
 Identify areas for continued process improvement to reduce denial
 Monitor action plan and track execution
 Analyze insurance denial trends identified via Meditech Exception Reports, Denial reports and other workflow
 Provide education and training as needed
 Establish and maintain relationships with all customers, including: SSC Leadership, Hospital Leadership, Division
Leadership and other customers
 Demonstrates knowledge of regulatory requirements, Ethics and Compliance policies, and quality initiatives;
monitors self-compliance and works with management to implement process changes needed to meet compliance
and regulatory updates, along with quality initiatives
 Seeks assistance from immediate supervisor when in situations which are unclear or ambiguous
 Actively seeks ways to control costs without compromising quality of services delivered
 Adheres to established policy and procedure and escalates issues through the established Chain of Command
 Demonstrates commitment to teamwork and cooperation
 Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
 Other duties as assigned

 Associates Degree or above in Business, Finance, Accounting or related field
 Equivalent work experience may substitute degree requirement
 Appeals, denials, managed care contracting, or case management experienced preferred
 Advanced Excel skill set and/or other data mining applications preferred
 Project Management experience preferred
 Previous management experience
 Some travel may be required