Beaumont Health System Denials Rep in Southfield, Michigan

Denials Rep Req #: 30110620 Category: Business Ops Facility: Beaumont Services Center Department: BBS Appeals Management Schedule: Full time Shift: DaysHours: 7:00a-3:30Pm Job Details:Job Summary:The Denials Analyst will be responsible for reviewing, researching and taking the next step based on the type of denial and protocol for the denial type. The Denials Analyst will provide a detailed monthly denial summary for each Beaumont Health facility.Job Responsibilities:Understanding of the revenue cycle and the responsibility and goals of each area and how they impact the revenue cycleReview all accounts that have has a payer denial based on the Denial Management Policy and Procedure and take appropriate action based on the type of denial.Understanding of current payer contractsApply corrections to patient demographics, charges, adjustments and paymentsIdentify and provide communication and education on trends identified on the monthly Denial LogAppeal denials based on the appeal criteria found within the Denial Management policyWork with facility departs when necessary for resolution or appeal of denials related to that department (i.e Lab, Patient Access, Case Management)Prepare and distribute a monthly denial log by facility to include account number, payor type, reason for denialIdentifies and communicates monthly denial trends and provides education as necessary to avoid recurring denials for the same denial reason codeDocument all findings and action taken in the Patient Accounting System following policy and procedure for documentation requirements.oMaintains a professional image and provides excellent customer serviceoAttends department meetings and education sessionsoMeets/exceeds performance expectations within required timeframes.oPractices and adheres to the "Code of Conduct" philosophy and Mission and Values statement.oSupports special projects as requested.oAdheres to all Beaumont Health Policies and ProceduresoPerforms other duties as assigned.Education:High School DiplomaLicensure/Certification/ Registration:HFMA CRCR certification within 6 months.Preferred Work Experience:Relative work experience in a health care based setting preferred.Knowledge of Revenue cycle structure and process.Must be detail oriented.Strong verbal and written communication skills.Proficiency in Excel, Word, PowerPoint and Access is necessary.Beaumont Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, , gender identity, orientation, age, status as a protected veteran, or status as a qualified individual with a disability.