JOB REQUIREMENTS Education Bachelor’s Degree, Business or Healthcare Administration required. Experience 1-3 years of healthcare experience with knowledge of the reimbursement / denials process.
Knowledge of reimbursement systems, Federal, State and payor-specific regulations pertaining to documentation and billing.
Knowledge of billing process, possesses process management, leadership and interpersonal skills. Must be proficient in spreadsheet, presentations, word processing and database applications.
Requires excellent written and verbal communication skills. Must be able to act independently, have meticulous follow-up skills, organizational skills, prioritization skills and experience working in a team environment.
Ability to interact well with physicians, physician offices, Business Office personnel, etc. to obtain appropriate information related to the reimbursement / denial process.
Physical Normal hospital business office environment. Extremely close eye work with use of computer up to 8 hours a day.
Hearing within normal range. Continuous sitting approximately 90% of the work day. Operates calculator, computer, copier and general office equipment.
Occasional walking, bending and lifting of 5-10 pounds. This is a safety sensitive position. Please see the St. Bernards Substance Abuse Policy for further information.
JOB SUMMARY Responsible for monitoring, tracking, aggregating and trending reimbursement and denials information according to discrete outpatient denial codes.
Will review for medical necessity. Analyze information related to infusion denials and follow up with appropriate action through the reimbursement and denial process.
Works with infusion center to prevent denials. Assists UM Coordinator with denials and appeals. Close out each tracked denial (overturned or recouped).
Overall works to increase revenue capture related to infusion center. Facility resource for denials / appeal process and regulatory compliance as it relates to the infusion center.
Must manage competing priorities, multi-task with results oriented outcomes and work in a fast-paced environment. This position is required to utilize independent judgement.
This position requires timely response to inquiries from payer. This position has high contact with physicians, clinical areas and business office.
Infusion Reimbursement Coord
Analyze information related to infusion denials and follow up with appropriate action through the reimbursement and denial process. Knowledge of reimbursement systems, Federal, State and payor-specific regulations pertaining to documentation and billing. Responsible for monitoring, tracking, aggrega...
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