Denial Operations Coordinator

$42,078 - $56,160/Yr

Nuvance Health - Danbury, CT

Full-time

Danbury, CT

Nursing and Residential Care Facilities

About the position

The Denial Operations Coordinator at Nuvance Health is responsible for identifying and communicating clinical denials in a timely manner. This role involves collaboration with various healthcare professionals and insurance companies to manage provider appeals and support the efficient operation of the department. The coordinator will handle administrative and clerical duties to ensure effective department functioning.

Responsibilities

• Reviews new and appeal upheld cases in work queue and incoming fax queue.
• Reviews denial letters through daily mail.
• Identifies retro denials and documents appropriately.
• Notifies new retro denials to nurses in a timely manner.
• Creates a weekly assignment for director to review for appeals.
• Communicates with insurance companies to schedule a peer-to-peer review and follow up on the outcomes.
• Sends the appeals with appropriate documents to the payors within the payors' timeframe.
• Documents and updates the denials in the denial tracking tool timely and accurately.
• Collects and analyzes the data as requested.
• Interacts professionally with team members within the department, other departments, and insurance companies.
• Demonstrates the ability to be flexible and organized during stressful situations.
• Fulfills all compliance responsibilities related to the position.
• Maintains and models Nuvance Health values.
• Demonstrates regular, reliable, and predictable attendance.
• Performs other duties as required.

Requirements

• High School Diploma
• Excellent interpersonal skills
• Organization skills
• Time management skills
• Experience with Windows based computer systems: MS Office - Word, Excel, MS Teams
• Good communication skills

Nice-to-haves

• Bachelor's degree
• Previous hospital or other healthcare setting experience

Benefits

• Equal opportunity employer
• Reasonable accommodation for applicants with disabilities