Professional Denials Coordinator

OverviewJoin Our Team at Oklahoma Heart Hospital (OHH)ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients' journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we're shaping the future of heart care in Oklahoma by serving the state and leading the nation.Why You'll Love Working Here:Comprehensive Benefits:Medical, Dental, and Vision coverage401(k) plan with employer matchLong-term and short-term disabilityEmployee Assistance Programs (EAP)Paid Time Off (PTO)Extended Medical Benefits (EMB)Opportunities for continuing education and professional growthPlease note that benefits may vary by position, and some roles (like PRN, Flex, Float, etc.) may have exclusions. For eligible positions, benefits start on your first day!We can't wait for you to join our heart-centered team!Location: Hartford: 7800 NW 85th Terrace, OKC OK 73132Shift: Full-Time, Days Monday-Friday.ResponsibilitiesThe Professional Denials Coordinator will work on targeted insurance denials to improve collections and reduce open balances. They will deal with inpatient notices of admission, authorizations, and subsequent denials. The Professional Denials Coordinator will assist with first and second level appeals under the Denials Manager's guidance. The Denials Coordinator will assist in identifying trends and finding root causes to prevent future denials, providing high-impact findings to the Denials Manager. Works under the guidance of a Denials Manager and Denials RN to prepare appeals on denials.Defend and appeal claims, including researching root cause, collecting required information, adjusting the account as necessary, resubmitting claims and all appropriate follow up activities.Submits requests to clarify clinical documentation for accurate coding of denials.Works with Denials Analyst and Underpayments Coordinator to call attention to areas of opportunity or system/process errors.QualificationsEducation: High school graduate or equivalent preferred.Experience: Minimum of two (2) years in professional/clinic Insurance Follow-Up or Denials. Clinical Denials experience is preferred; Epic experience is a plus but not required. CPC is strongly encouraged.Working Knowledge: Insurance collections and denials, with an emphasis on professional coding is preferred.As part of our team, you are empowered to work collaboratively with our physicians and other caregivers, and play an integral role in setting the standard for excellence in patient care.Every team member at OHH plays an integral role in our patients' experience. Theyare the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care.The Professional Denials Coordinator will work on targeted insurance denials to improve collections and reduce open balances. They will deal with inpatient notices of admission, authorizations, and subsequent denials. The Professional Denials Coordinator will assist with first and second level appeals under the Denials Manager's guidance. The Denials Coordinator will assist in identifying trends and finding root causes to prevent future denials, providing high-impact findings to the Denials Manager. Works under the guidance of a Denials Manager and Denials RN to prepare appeals on denials.Defend and appeal claims, including researching root cause, collecting required information, adjusting the account as necessary, resubmitting claims and all appropriate follow up activities.Submits requests to clarify clinical documentation for accurate coding of denials.Works with Denials Analyst and Underpayments Coordinator to call attention to areas of opportunity or system/process errors.Education: High school graduate or equivalent preferred.Experience: Minimum of two (2) years in professional/clinic Insurance Follow-Up or Denials. Clinical Denials experience is preferred; Epic experience is a plus but not required. CPC is strongly encouraged.Working Knowledge: Insurance collections and denials, with an emphasis on professional coding is preferred.As part of our team, you are empowered to work collaboratively with our physicians and other caregivers, and play an integral role in setting the standard for excellence in patient care. Every team member at OHH plays an integral role in our patients' experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care.