Government Audit & Appeals Program Coordinator (Remote)

Overview The Government Audit and Appeals Program Coordinator supports the department with operations and management of the appeals process. Reports to the Sr. Manager of Government Audit and Appeals and works closely with Government Audit and Appeal Specialists, the Patient Financial Services (PFS) department, Professional Billing Office (PBO), Health Information Management Services (HIMS), payors, and reviewer entities to ensure a timely and effective appeals process. Locations Stanford Health Care What You Will Do Adhere to Stanford Health Care’s organization competencies and Code of Conduct. Manage all appeals correspondences, systematically tracking records requests, findings letters, and stages of appeals within the tracking tool/application. Triage and monitor EPIC work queues and team email for payor denials, disseminating to the appropriate department according to content. Maintain routine clerical operations and communications. Self‑sufficient individual who can problem‑solve, prioritize, and facilitate complex projects in daily activities. Follow up with payors and/or reviewing entities to inquire about the status of appeals, ensuring timely updates and addressing any additional information or documentation required. Coordinate with HIMS to follow up on tracking information for submitted documentation such as medical records and appeals to payors and reviewing entities. Assist with the timely filing of government appeals, facilitating communication among team members, ensuring all necessary documentation is submitted within required deadlines, and monitoring the progress of each appeal to address issues promptly. Provide data analytics on appeals outcomes, summarizing information for internal or external constituents, and preparing documents, reports, and presentations for meetings and events. Manage team calendars, schedule meetings, and transcribe minutes with action items. Education Qualifications Bachelor’s degree in a work‑related discipline or field from an accredited college or university (or equivalent combination of education/experience). Experience Qualifications Three to five (3‑5) years of equivalent experience in coding, auditing, or program coordination in a hospital, large healthcare system, or major corporation. Required Knowledge, Skills and Abilities Ability to support the effectiveness and continuity of the Government Audit and Appeal program. Organized with strong project management skills and able to influence others without direct authority. Ability to manage and prioritize multiple tasks, meet deadlines, and follow through on assigned duties while maintaining a service‑oriented approach. Excellent verbal and written communication skills. Analytical and critical thinking skills. Strong computer skills, including basic keyboarding and proficiency in Microsoft Office (Word, Excel, PowerPoint, Outlook); Microsoft Visio proficiency preferred. Knowledge of general state and federal requirements related to patient privacy and confidentiality. Ability to maintain confidentiality of sensitive information in accordance with applicable laws, policies, and rules. Effective communication and presentation skills. Adaptability to changing priorities and shifts in denials and appeals activity while maintaining high standards of accuracy and compliance. Licenses and Certifications CCS – Certified Coding Specialist (preferred) CIC – Certified Inpatient Coder (preferred) RHIT – Registered Health Information Technician (preferred) RHIA – Registered Health Information Administrator (preferred) COC – Certified Outpatient Coder (preferred) Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non‑discrimination in all of its policies and practices, including the area of employment. SHC does not discriminate on the basis of race, color, sex, sexual orientation, gender identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements. Base Pay Scale Generally starting at $41.68 – $54.19 per hour. The final salary will be based on factors such as internal equity, experience, education, specialty, and training. This pay scale is not a promise of a particular wage. #J-18808-Ljbffr Stanford Health Care