Denials Management Coordinator II

Description

Summary:
The Denial Management Coordinator II role is responsible for continuous process review, analysis, recovery, and management of denials for MaineHealth entities operating on the Epic system, using Epic reporting, Collect/Score Logix, and other custom reports and software to track, trend, and identify root causes of denials. Summarizes and facilitates opportunities, solutions and results to leadership in a formalized presentation on an ongoing basis. Precepts, trains and provides coaching to new team members.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

1. Education: Associate's Degree in Healthcare Administration, Business, or Finance preferred. Higher education may be substituted for an additional year of experience in revenue cycle.
2. License/Certifications: Required to obtain certification through HFMA for Certified Revenue Cycle Representative or through AAHAM for Certified Revenue Cycle Professional or Certified Revenue Cycle Specialist. Certification as a medical coder through AHIMA (CCA, CCS, CCS-P) or through AAPC (CPC-A, CPC, COC, CIC) preferred.
3. Experience: Four years of experience in revenue cycle required. Two years of direct denials management experience required. EPIC experience required. Demonstrates competency in all essential functions of a Denial Management Coordinator I role.
4. Additional Skills/Requirements Required: N/A
5. Additional Skills/Requirements Preferred: Advanced computer analytical skills in Microsoft Office Suite. Knowledge of revenue cycle processes, medical billing and coding processes, CPT, HCPCS, ICD10, NCCI edits, and Medicare LCD/NCDs

If you have questions about this role, please contact Zachary T. Avelino at zachary.avelino@mainehealth.org