Singing River Health System · 1 month ago
Denials and Appeals Analyst
Gautier, MS
Full-time
Onsite
Senior Level
5+ years expSinging River Health System is seeking a Denials and Appeals Analyst to assist in the recovery of health system revenue by resolving denied claims. The role involves coordinating the appeals process for denied claims and collaborating with various departments to achieve quality and financial goals.
Health CareHospitalMedicalNon ProfitSports
Responsibilities
Assists in the recovery of Health System revenue by bringing denied claims to full resolution
Works collaboratively with departmental peers throughout the System to achieve departmental and system-wide quality, satisfaction, and financial goals
Coordinates the appeals process for denials deemed appropriate by the Patient Financial Services Director and the Denials Manager
Assures that prompt action is taken on assigned denials by coordinating with clinical staff to create written and/or verbal clinical appeals with payers
Works closely with third party payors, Managed Care representatives, insurance billing staff, case management, and other service departments to resolve denied claims
Acts as a liaison and communicates denials related information and knowledge to Organizational Leaders
Qualification
Required
High School Diploma or equivalent
Must have de-escalation training completed by the end of position orientation (90 days)
A minimum of five (5) years' patient accounting and insurance experience
Must demonstrate keen mental faculties/assessment and decision making abilities
Must demonstrate superior communication/speaking/enunciation skills to receive and give information in person and by telephone
Must demonstrate strong written and verbal communication skills
Must possess emotional stability conducive to dealing with high stress levels
Must demonstrate ability to work under pressure and meet deadlines
Attention to detail and the ability to multi-task in complex situations is required
Must have the ability to maintain collaborative and respectable working relationships throughout SRHS and other organizations
Must possess superior customer service skills and professional etiquette
Must possess proficient knowledge and ability to use a computer (must be keyboard proficient) and other office technology (i.e., telephone, fax, etc.), MS Outlook and Word
Job may require traveling throughout the SRHS service area - with the employee providing their own transportation
Travel for education purposes may be required
Preferred
Associate's degree
Epic certification in Resolute Hospital Billing
Certified Coding Specialist
Experience in a hospital and/or physician office
Company
Singing River Health System
Singing River offers award-winning, comprehensive care for every age and stage.
Founded in 1931Pascagoula, Mississippi, USA
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Jason McNeil, CPA, MBA
Chief Financial Officer
Laurin St. Pe
Chief Operating Officer
Company data provided by crunchbase