Denial Coordinator - Hybrid

$39,520 - $45,760/Yr

Astrana Health - Monterey Park, CA

Full-time - Entry Level

Hybrid - Monterey Park, CA

About the position

Astrana Health is seeking a Denial Coordinator to join our Health Services - Denials department. This full-time position is designed to support our growth in the healthcare industry by ensuring the timely and accurate processing of deferrals and denials. The Denial Coordinator will report directly to the Manager-Denial and will work in a hybrid capacity, splitting time between the office and remote work on a weekly basis. The role is critical in maintaining the integrity of our healthcare management processes and requires a commitment to confidentiality and patient privacy in compliance with HIPAA regulations. In this role, the Denial Coordinator will be responsible for reviewing and processing daily assigned deferrals or denials, which may include denial, modification, or carve-out actions. The expectation is to handle a minimum of 30-40 letters per day, ensuring accuracy and quality in all communications. The coordinator will also be tasked with monitoring the daily Failed Fax Report for denials and deferrals, ensuring that all necessary letters and notifications are refaxed and documented appropriately. Additionally, the coordinator will engage in daily monitoring of the Denial Inquiry, responding to provider or interdepartmental emails, and documenting all interactions in the referral notes as needed. The Denial Coordinator will play a vital role in upholding the values of Astrana Health, which include putting patients first, empowering provider teams, operating with integrity and excellence, being innovative, and working collaboratively as one team. This position is essential for maintaining the high standards of care that our organization strives to provide to over 1 million patients nationwide. The work environment is dynamic, and the coordinator will be expected to adapt to various tasks and projects as assigned, contributing to the overall mission of improving patient outcomes and increasing access to quality healthcare.

Responsibilities

• Comply with NMM and department policies and procedures to ensure timely and accurate processing of all deferrals and or denials.
• Review and process daily assigned deferrals or denials (denial, modify, carve out, etc.) with a minimum of 30-40 letters per day with accuracy and quality.
• Ensure daily Failed Fax Report for denials and deferrals is reviewed and letter/notification refaxed and documented in the referral.
• Ensure daily monitoring of the Denial Inquiry; refax denial notification or letter, respond to the provider or interdepartmental emails, and document in the referral notes as needed.
• Maintain a high level of integrity and confidentiality/patient privacy (HIPAA) of all information (written, verbal, electronic, etc.) that an employee encounters.
• Perform other duties, projects, and actions as assigned.

Requirements

• High School Diploma or GED
• 1+ years of experience working in the healthcare industry
• Experience using Microsoft applications such as Word, Excel, and Outlook
• Ability to communicate with multiple clients at a time.