Denials Coordinator - Hospital Billing Patient Financial Services - Corporate 42nd Street - Ful[...]

Job Description Denials Coordinator – Hospital Billing Patient Financial Services – Corporate 42nd Street – Full-Time – Days A hospital denial coordinator manages and resolves denied insurance claims to help the hospital recover revenue. Key responsibilities include analyzing claim denial reasons, identifying denial trends, sharing trends and findings with owner areas, coordinating the appeals process, collaborating with departments to prevent future denials, maintaining documentation including issue logs with updates, denied dollars and resolutions, and acting as a resource for staff regarding denial-related issues and payer rules. This person will also escalates issues to management if deadlines are missed, payer responses are not received, or when barriers or process gaps are identified. Qualifications HS/GED; Bachelors degree preferred Three years of experience within hospital healthcare revenue cycle, performing administrative or process improvement type functions Strong knowledge of Epic Resolute hospital billing Knowledge of healthcare revenue cycle, insurance policies, coding (ICD-10, CPT), and denial management systems. Strong analytical and problem-solving skills. Excellent communication and interpersonal skills to collaborate with internal teams and external payers. Ability to organize and manage multiple tasks and deadlines. Proficiency with relevant software and databases, including Electronic Medical Records (EMRs). Non-Bargaining Unit, 518 - PFS 633 Third Avenue - MSH, Mount Sinai Hospital Responsibilities Analyze Denials: Review and investigate denied insurance claims to understand the specific reasons for denial Appeal Management: Initiate, track, and coordinate the appeals process for denied claims, ensuring all necessary documentation and timely follow-up are completed. Trend Identification: Analyze denial data to identify patterns and root causes of denials and underpayments. Process Improvement: Work with various hospital departments (e.g., coding, billing, clinical) to develop and implement solutions to prevent future denials and improve processes. Payer Relations: Maintain relationships with insurance payers to facilitate claim resolution and address ongoing issues. Documentation and Reporting: Maintain accurate records of all denial and appeal activities, including logs and system records, and prepare reports for management on denial trends. Includes routine report outs of identified trends, next steps, resolutions or barriers to resolution. Resource: Serve as point of contact for staff questions regarding denial rationale, timely filing, payer policies, and the appeals process. Compliance: Ensure adherence to regulatory compliance, such as HIPAA, and stay informed about payer and Medicare/Medicaid guidelines. Equal Opportunity Employer The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization. Compensation Statement Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $65885 - $98827 Annually. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits. #J-18808-Ljbffr Mount Sinai Health System