What are the responsibilities and job description for the Denial Mgt & Rev Integ Spec position at Mercy?
We’re a Little Different
Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.
At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.”
Overview:
Under the direction of the Supervisor of Denial Management & Revenue Integrity, the Denial Management & Revenue Integrity Specialist will be responsible for analyzing denied claims, underpaid and nonpaid claims working with key stakeholders and payors to investigate the reason for denial to determine the appropriate course of action and initiate remediation steps as appropriate. The Denial Management & Revenue Integrity Specialist will also be responsible for writing formal appeals and escalating claims for clinical or business review as appropriate. Denials will include all patient types.
Qualifications:
- Education: Associate's degree in healthcare-related field
- Licensure: CCDS (ACDIS Certified Clinical Documentation Specialist), or CDIP (AHIMA Certified Documentation Improvement Practitioner. Registered Health Information Technician Certification (RHIT), or Certified Coding Specialist Certification (CCS), or CHC (Certified Healthcare Compliance) required.
- Experience: 2 years of direct healthcare experience with demonstrated expertise in revenue cycle functions as it relates to billing, coding, denial management and third-party payer requirements
- Other Skills and Knowledge:
- Excellent critical thinking skills with the ability to quickly make decisive decisions from limited written and/or oral information, excellent reading comprehension
- Excellent communication skills with ability to express oneself in writing and orally; and comfortable speaking in groups.
- Ability to plan and organize workflow in order to meet deadlines
- Ability to produce reports using multi-formats and software, i.e. Word, Excel
- Ability to present data findings/report to leadership as needed.
- Ability to establish cooperative working relationship with diverse groups and individuals, medical staff and other health care disciplines and interact with all levels of employees
- Employee should possess: the ability to work with minimum supervision; organizational and administrative skills; function in a stressful environment; encourage and assist with team building; and the ability to maintain the confidentiality of sensitive information, both patient and employee
Preferred Qualifications
- Education: Associates or Bachelors degree in healthcare-related field
- Licensure:CCDS (ACDIS Certified Clinical Documentation Specialist), or CDIP (AHIMA Certified Documentation Improvement Practitioner. Registered Health Information Technician Certification (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Specialist Certification (CCS), or CHC (Certified Healthcare Compliance) required.
- Experience: 5 years of direct healthcare experience within the revenue cycle function as it relates to billing, coding, denial management and third-party payers
We Offer Great Benefits:
Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period!
We’re bringing to life a healing ministry through compassionate care.
At Mercy, our supportive community will be behind you every step of your day, especially the tough ones. You will have opportunities to pioneer new models of care and transform the health care experience through advanced technology and innovative procedures. We’re expanding to help our communities grow. Join us and be a part of it all.
What Makes You a Good Match for Mercy?
Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We’re also collaborative and unafraid to do a little extra to deliver excellent care – that’s just part of our commitment. If that sounds like a good fit for you, we encourage you to apply.
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