Prebill Denials Coordinator in Nashville, TN at Parallon

Date Posted: 7/5/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Nashville, TN
  • Job Type:
    Other
  • Experience:
    Not Specified
  • Date Posted:
    7/5/2018

Job Description



Job Summary – The Prebill Denials Coordinator will serve as the SSC liaison for the Denial Management Action Team (DMAT) Project and identify areas for continued process improvements through data and reporting analysis that will further decrease new denials, final write off denials, and prebill denials. Works with SSC leadership, Division Leadership and others on process improvement opportunities.

Supervisor – Prebill Denials Director/Manager

Supervises – not applicable

Duties (included but not limited to):

• Serve as the SSC Liaison for the Denial Management Action Team (DMAT) Project

• Submits standard monthly denial reports to Division Denial Management

• Monitor, record, communicate and escalate denial action items based on DMAT project findings to SSC leadership

• Serve as scribe for the DMAT facility meeting if requested by Division, Facility, or SSC leadership

• Facilitate the SSC DMAT meetings, along with others as assigned by SSC Leadership.

• Assist with identifying areas for continued process improvement to reduce denial via Division, Facility, and SSC DMAT meetings as well as reporting and data analysis.

• Analyze denial trends identified via applicable reports such as EDW, Visual Insight, special queries and other workflow tools

• 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

• When time permits, assist the Prebill Denial Unit by working assigned accounts in the PDU Tool.

• Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"

 

• Other duties as assigned

EDUCATION

• Associates Degree or above in Business, Finance, Accounting or related field

• Equivalent work experience may substitute degree requirement

EXPERIENCE

• One year of related experience required. Experience in the following areas: appeals, denials, managed care, verifications/notification, precertification, project management experienced preferred.

• Some travel may be required.