Denial Appeals Coordinator - Remote

Job description

Job Summary The Denials & Appeals Coordinator is responsible for managing, tracking, and resolving denials and appeals to ensure timely reimbursement. This role requires in-depth knowledge of payer guidelines, systems, and requirements to navigate complex denial cases effectively, assist in issue resolution, and help identify trends that can improve claim outcomes. Essential Functions: - Monitors assigned queues and duties across various systems (such as, Artiva, HMS, Hyland, BARRT) to ensure all follow-up dates are current. - Analyzes denials to determine appropriate actions, completes appeals, or routes cases for clinical appeals as needed. - Files and monitors appeals to resolve payer denials, documenting all activity accurately and maintaining logs, account notes, and system records. - Maintains an up-to-date understanding of payer guidelines and requirements related to denials and appeals. - Processes BARRT requests, reviews RAC/Government Audit accounts, and completes necessary rebills and adjustments. - Identifies trends in denials to suggest improvements and reduce future claim issues, providing data for denial and appeal trends as needed. - Performs other duties as assigne...