Denial Coordinator
Job Description
JOB DETAILS
REQUIREMENTS
- High school diploma or equivalent required; associate degree in Health Information Management, Business, or related field preferred.
- Minimum of 3 years of experience in healthcare denials or appeals management required, preferably in a hospital or large practice setting.
- Proficiency in Epic work queues and denial tracking tools.
- Strong organizational and communication skills with attention to detail.
- Ability to work collaboratively across departments and manage multiple priorities efficiently.
RESPONSIBILITIES
- Manage and monitor denial and appeal work queues in Epic to ensure timely completion and proper routing.
- Coordinate appeal cases, ensuring all required documentation and letters are prepared, reviewed, and faxed or submitted to payers within defined timelines.
- Lead the daily prioritization and distribution of denial cases among team members to maintain workflow efficiency.
- Identify and troubleshoot issues related to system functionality or workflow barriers and escalate as appropriate.
- Track denial trends and assist in root cause analysis to support proactive process improvements.
- Collaborate with coders, auditors, and billing staff to gather documentation and clarify appeal requirements.
- Maintain accurate records of all correspondence, submissions, and appeal outcomes.
- Provide guidance, training, and support to denial coordination staff as needed.
- Participate in meetings and contribute to continuous improvement of denial management processes.
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