What are the responsibilities and job description for the Case Management Denials Coordinator position at Cabell Huntington Hospital?
Cabell Huntington Hospital is seeking a full-time Denials Coordinator to work alongside our Clinical Resource Management Department.
The Denial Coordinator exercises independent judgment and professional discretion in the practice of case management to a select group of patients. They collaborate with URS and physicians to ensure that patients are at the appropriate level of care with the use of clinical based guidelines such as InterQual. The Denial Coordinator provides necessary documentation for appeal of denials and provides updates to the billing department of the denial/appeal statuses. They utilize collaborative problem solving skills to meet the needs of the patients and physician while meeting the contractual guidelines of our payers.
Requirements:- Bachelor's degree in Nursing required.
- 5 Years of Position-Related Experience required.
The kind of position-related experience includes:
Clinical expertise in area of responsibility and management of patients in designated area: Utilization management principles including but not limited to insurance authorizations, denial management, appeal management; excellent verbal and written communication skills; Builds effective relationships with the healthcare team; demonstrates critical thinking skills; Clinical and leadership skills, performance improvement, DRG's, analytical skills.
