The denials coordinator manages and appeals rejected healthcare insurance claims to recover revenue for Central Care Cancer Center.
- Review Denied Claims: Examine insurance explanation of benefits and electronic medical records to find the exact reason for a claim denial.
- Draft and Submit Appeals: Write appeal letters, attach clinical notes/medical records, and resubmit corrected claims to insurance companies.
- Analyze Root Causes: Track denial trends and patterns to identify recurring billing, coding, or authorization errors and report them to management.
- Collaborate Internally: Work with medical coders, billers, and clinical staff to gather missing documentation and clarify patient accounts.
- Communicate with Payers: Contact third-party insurance providers via phone or online portals to check claim statuses and verify policy requirements.
- High School Diploma, required. Associate's or Bachelor's Degree in Healthcare Administration, Business, or nursing is preferred.
- 1-4 years experience in medical and radiation oncology billing, revenue cycle management, (Medicare, Medicaid, and commercial) claims processing, or insurance follow-up.
- Familiarity with Electronic Health Records (EHR) and billing software, such as Meditech.
- Understanding of medical coding standards (ICD-10, CPT, HCPCS) and insurance regulations.
