Community Health Systems SSC Denials Coordinator in Antioch, Tennessee

Description:

Community Health Systems (CHS) Shared Services Center (SSC) Nashville, is hiring a Denials Coordinator. This position is responsible for working with the denials and appeals processes within the context of a hospital environment, dealing with insurance contracts and payer policies.

CHS is one of the leading operators of general acute care hospitals in the nation. The organizations affiliates own, operate or lease 118 hospitals in 20 states (mainly in the SE) with approximately 20,000 license beds and 90,000 employees. These affiliated hospitals are dedicated to providing quality healthcare for local residents and contribute to the economic development of their communities.

This position supports revenue cycle operations on behalf of the SSC assigned facilities (hospitals). The affiliated hospitals viability is based upon the SSC's ability to collect revenues for those services. In over 60 of the markets served, CHS affiliated hospitals are the sole provider of healthcare services.

Essential Duties and Responsibilities: include the following (Other duties may be assigned),

• Complete monthly denial logs in required time frame.

• Attend monthly denial meetings with facilities as assigned.

• Communicate with all necessary departments to identify and resolve denial trends and issues.

• Review and analyze all denial trends and issues as assigned.

• Maintain working knowledge of all payer guidelines and requirements as they relate to denials and appeals.

• Monitor and work all denials and appeals as assigned.

• Properly track and document all denial and appeal activity.

• Maintain all logs, account notes and system records as assigned.

• Review outpatient RAC denials and appeal as needed.

• Monitor AB rebills that needed on RAC accounts and post recovery or denial adjustments as needed.

• Monitor assigned duties in C360, and ensure proper handling of all RAC accounts.

Qualifications

Qualifications/Knowledge/Abilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Working knowledge of denials and appeal processes including a basic understanding of contracts and payer policies.

• Familiar with current medical terminology.

• Understanding of the healthcare (specifically hospitals) revenue cycle process.

• Ability to communicate effectively, both verbal and written.

• Able to work independently and to meet deadlines.

• Minimum of one year experience in a healthcare setting (preferably hospitals).

• Ability to define problems, collect data, validate data, establish facts, and draw valid conclusions.

Computer Skills:

• Working knowledge of MS Office tools (Word, Excel and Outlook).

Education/Experience:

• High school diploma or equivalent. Any education beyond HS is an added bonus.

• Minimum of one year experience in a healthcare setting (preferably hospitals).

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Please note: This position requires that you work out of the newly constructed Cane Ridge Shared Services Center (SSC) in Antioch, TN.

Job: Business Office

Organization: Shared Services Center - Franklin

Location: TN-Antioch

Requisition ID: 1839047

This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment.