Government Audit & Appeals Program Coordinator (Remote)

A Brief Overview The Government Audit and Appeals Program Coordinator supports the department with operations and management of the appeals process. The Program Coordinator will work closely with the Government Audit and Appeal Specialists, Sr. Manager of Government Audit and Appeals, 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 is maintained. The Government Audit and Appeals Program Coordinator reports to the Sr. Manager of Government Audit and Appeals. Location Stanford Health Care What you will do Adheres to Stanford Health Care’s organization competencies and Code of Conduct. Manages all appeals correspondences by systematically tracking records requests, findings letters and stages of appeals throughout the course of the appeals process within tracking tool/application. Triage and monitor EPIC work queues and team email for payor denials and disseminates to appropriate department according to content. Responsible for the maintenance of all routine clerical operations and communications. Self-sufficient individual who can problem-solve, prioritize and facilitate complex projects in the course of their 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 they may require facilitating the review process. Internal coordination in assisting with HIMS follow up on tracking information for submitted documentation such as medical records and appeals to payors and reviewing entities. Coordinate and assist with the timely filing of government appeals by facilitating communication among team members, ensuring all necessary documentation and/or appeals are submitted within required deadlines, and monitoring the progress of each appeal to address any issues that may arise promptly. Provide data analytics on appeals outcomes to gain valuable insights into the effectiveness of their appeals process. Summarize information for internal or external constituents. Prepare and organize documents, reports, and presentations for meetings and events. Manage team calendars scheduling meetings and transcribe minutes with action items. Education Qualifications Bachelor’s degree in a work-related discipline/field from an accredited college or university (or equivalent combination of education/experience). Experience Qualifications Three to five (3-5) years equivalent combination of 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 effective in influencing others without having direct lines of authority. Ability to manage and prioritize multiple tasks; ability to meet deadlines and follow through on assigned duties; ability to work well under pressure; ability to maintain a service-oriented approach. Excellent verbal and written communication skills. Analytical and critical thinking skills. Strong computer skills, including basic keyboarding skills, and Microsoft Office (Word, Excel, PowerPoint, Outlook) proficiency. Microsoft Visio proficiency, preferred. Knowledge and understanding of general state and federal requirements pertaining to patient privacy and confidentiality. Ability to maintain confidentiality of sensitive and confidential information in accordance with applicable laws, policies and rules. Demonstrates effective communication and presentation skills. Ability to adapt 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. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. 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 salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage. #J-18808-Ljbffr LE0010 Stanford Health Care