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Payer Audit Management Denial Coord

Location: Denver, CO, United States
Category: Professional/Management
Job Type: Full Time
Job ID: 65932
Date Posted: Sep 13, 2022

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Description

Payer Audit Management Denial Coordinator

This is a full-time (40 hrs/wk), exempt/salaried, Days position on UCHealth’s Payer Audit Management team. You may be based in Fort Collins, Metro Denver or Colorado Springs. Provides services to recover potential loss in revenue as a result of payer denials.

Job duties

· Analyzes data to recover potential loss in revenue as a result of payer denials. Determines if appeals should be filed; initiates appeals and manages denied appeals within the timeframes and guidelines of each given payer.

· Coordinates response of other stakeholders in payer audits including legal counsel and health information management.

· Analyzes denial issues and pinpoints trends. Provides feedback regarding workflow improvement opportunities to leadership.

· Serves as a Recovery Audit Contractor (RAC) program subject matter expert. Works with the Government Audit Program Administrator to compile materials and reports with follow up communication. Tracks status of payer audit activities.

· Participates in system wide audit activities. Applies industry standard criteria to assist in determination of the appropriate level of patient care. Facilitates accurate reimbursement.

Required

· Associate’s Degree in Nursing or healthcare related field

· 3 years of healthcare coding experience for inpatient and outpatient hospitals OR 3 years of experience in acute care nursing

· 1 year of Utilization or Case Management experience OR previous denial management experience

Preferred

· Bachelor’s Degree

· Registered Health Information Administrator (RHIA) or healthcare-related coding certification.

· 5 years of healthcare coding experience in inpatient and outpatient hospitals.

· 2 years of health care experience emphasizing health care operations, government regulatory rules and guidelines, policy development, or compliance.

· Project management or revenue integrity experience.

The pay range for this position is$27.61 - $41.41 / hour. Pay is dependent on applicant's relevant experience.

 

UCHealth offers a Five Year Incentive Bonus to recognize employee’s contributions to our success in quality, patient experience, organizational growth, financial goals, and tenure with UCHealth. The bonus accumulates annually each October and is paid out in October following completion of five years’ employment.

UCHealth offers their employees a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical, dental and vision coverage; retirement plans; paid time off; employer-paid life and disability insurance with additional buy-up coverage options; tuition and continuing education reimbursement; and a full suite of voluntary benefits such as identity theft protection and pet insurance. Our employees and their family members have full access to our Employee Assistance Program, which includes up to 5 free counseling visits and work/life solutions, such as one free legal consultation. In addition, other emotional counseling support is available depending upon their need.

At UCHealth, we do things differently

We believe in something different: a focus on the individuality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve. As Colorado’s largest and most innovative health care system, we as a team deliver on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at UCHealth is more than a job, it’s a passion.

Going beyond quality requires the perfect balance of talent, integrity, drive and intellectual curiosity. We are looking for individuals who recognize, like us, that the world of medicine is ever-changing and are motivated to do what is right, not what is easy. We support creativity and curiosity so that each of us can find the extraordinary qualities within ourselves. At UCHealth, we’ll do everything in our power to make sure you grow and have a meaningful career. There’s no limits to your potential here.

Be Extraordinary. Join Us Today!

UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an affirmative action/equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual’s race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status. UCHealth does not discriminate against any “qualified applicant with a disability” as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.

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