Denials Assistant - Remote

Job Description

Description

PeaceHealth is seeking a full time Denials Assistant.....

The salary range for this job opening at PeaceHealth is $17.06 – $25.58. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.  This remote role requires the incumbent to reside in OR, WA, AK or TX by date of hire.

Denials Assistant coordinates the flow of DRG denial letters through multiple systems for receiving, processing, and finalizing denials. Provides support to HIM Coding Process Analyst in answering email questions regarding denials, maintaining a wide range of payer deadlines, and reporting on denial functions.

What you will enjoy:

• Processes letters from physician reviewer group on a timely basis.
• Reviews letters for accuracy, makes minor changes, saves letters to correct folders, and labels for processing.
• Sorts denial letters from email into correct folders and label for processing.
• Responds to emails with questions regarding DRG denials.
• Moves denials through Code Audit system as different steps occur.
• Prepares appeal packets, pulls supporting documentation from electronic health record.
• Faxes/Emails/Uploads appeals to various payers in a timely manner.
• Maintains a wide range of payer deadlines and ensures all denials are reviewed within the given time limit.
• Monitors correspondence work queues for new correspondence related to DRG denials.
• Routes clinical denials and rebuttals to different departments for review/appeal.
• Compiles and sends weekly reports on denials without recoupment amounts.
• Performs other duties as assigned.

What you will bring:

• High School Diploma or equivalent preferred.
• College Coursework with an emphasis in Medical Terminology, Health Information Management, Project Management, Office Administration, Microsoft Office (Excel, Word, PowerPoint, Outlook) preferred.
• Minimum of 1 year General office, administrative experience preferred.
• Basic knowledge of general office procedures and equipment preferred.

Additional Skills:

• Ability to use a complex EMR system preferred.
• Ability to work independently with minimal supervision. 
• Proficient computer and keyboard including MS Office applications. 
• Good judgment and decision-making skills. 
• Strong organizational skills. 
• Multi-task/detail oriented. 
• Ability to handle interruptions due to phone calls, emails and questions.
• Use of Teams technology to communicate with peers in different locations. 
• Good verbal and written communication skills. 
• Able to maintain a high degree of confidentiality. 

Working Conditions

• Consistently operates computer and other office equipment.
• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
• Sedentary work.
• Predominantly operates in an office environment.
• Ability to communicate and exchange accurate information.
• The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.

PeaceHealth requires a completed Primary Vaccine Series (e.g., 2 dose monovalent Pfizer, Moderna or Novavax series or 1 dose J&J vaccine series) or be Up to Date (receiving the most recent Pfizer/Moderna bivalent vaccine/booster) for COVID-19 vaccination prior to their start date. PeaceHealth has a medical and religious exemption request process for those that are unable to receive the COVID-19 primary vaccine series due to medical/religious reasons. For caregivers that will be working in Oregon there is a personal vaccine exemption form that may be requested.