What are the responsibilities and job description for the Denials Management Analyst / Scheduler position at Trinity Health System?
JOB SUMMARY :
Works collaboratively with physicians, staff and other health care professionals at all three acute care facilities to review, address and prevent denials – technical, medical necessity, and others.
Collaborates with all revenue cycle team members on daily case issues as well as developing system-wide quality improvement / performance improvement initiatives. Identify denials trends and develop appropriate plans to reduce.
Schedule patients for Hospital testing as needed—this position will schedule for vacations, backlog, call offs etc. On the average, scheduling function should only be approximately 8 hours per week
QUALIFICATIONS :
Required Education and Experience
BS / BA in Health Related Field or Finance preferred.
Training, Required Licensure and Certifications
Experience with hospital billing and collections processes, skills demonstrated in appealing and reducing denials
Scheduling Experience a plus
Independent thinking and decision-making ability in appealing and reducing denials
Excellent written, verbal, and interpersonal skills; ability to work in a team environment as well as independently
Strong analytical skills necessary to collect, analyze and interpret denials data, resolve complex problems
Preferred : Medical record audit and program development experience and public speaking, working knowledge of Interqual / Milliman admission criteria
ESSENTIAL KEY JOB RESPONSIBILITES :
Provide guidance and support for all denials prevention.
Actively manage, maintain and communicate denial / appeal activity to appropriate stakeholders and report suspected or emerging trends related to payer denials to Revenue Cycle management.
Coordinates large dollar denials for follow-up.
Work with PIC tool to identify and resolve payment variances
Assist with the development and implementation of policies, procedures, standards and initiatives to reduce denials.
Work with revenue cycle denials team to identify denials issues and processes to correct using the denial software tool.
Schedules patients for Hospital testing as needed
Actively participate in monthly revenue cycle denial meetings to help reduce overall denials.
Reports any trending and process improvement initiatives to CFO and key stakeholders
Collaborates in the ongoing re-design and re-engineering of Denial functions, to meet the changing needs and priorities of the organization.
Keep a pulse on the job market with advanced job matching technology.
If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution.
Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right.
Surveys & Data Sets
What is the career path for a Denials Management Analyst / Scheduler?
Sign up to receive alerts about other jobs on the Denials Management Analyst / Scheduler career path by checking the boxes next to the positions that interest you.
