Job ID86601

LocationAurora, Colorado

Full/Part TimeFull-Time

Regular/TemporaryRegular

Why Work at Children's....

Here, it's different. Come join us. Children's Hospital Colorado has defined and delivered pediatric healthcare excellence for more than 100 years. Here, the nation's brightest nurses, physicians, scientists, researchers, therapists, and care providers are creating the future of child health. With an optimist's outlook, a trailblazing spirit, and a celebrated history, we're making new strides every day. We've been Magnet-designated four times by the American Nurses Credentialing Center and are consistently recognized among the best of the best pediatric hospitals with #1 rankings in Colorado and the region by U.S. News & World Report. As a national leader in pediatric care, we serve children and families from all over the nation. Our System of Care includes four pediatric hospitals, 11 specialty care centers, 1,300+ outreach clinics and more than 10,000 healthcare professionals representing the full spectrum of pediatric care specialties. Here, we know it takes all of us, every role, to deliver the best possible care to each child and family we treat. That's why we build our teams toward a foundation of equity in access, advancement, and opportunity. We know teams of individuals with different identities and backgrounds can nurture creativity and innovation. We know we can see, treat, and heal children better when our team reflects the diversity of our patient population. We strive to attract and retain diverse talent because we know a truly inclusive and equitable workforce will help us one day realize our most basic calling: to heal every child who comes through o A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child. Here, it's different.

Job Overview

Position supports all denials management functions for Patient Financial Services, maintains and updates denials management data, and conducts analyses for trending and reporting. The position will also be responsible for conducting root-cause analysis of denials, interacting and meeting with departments throughout the hospital requiring assistance in addressing denials, be responsible for working denials that are escalated to them for review and resolution, work with PFS or other departments to develop and maintain all denials management training and guidelines. This position requires strong partnering with management and staff in PFS, Ambulatory Services, Case Management, Patient Access and HIM.

Additional Information

Department Name: Patient Finantial Services Job Status: Full time, 40 hours per week. Shift: Day shift, Monday to Friday, 8am to 4:30pm, hybrid

Qualifications

General Work Experience: Three to five years prior experience in a healthcare or related field (front-line clinic, billing office and/or admissions department) with exposure to billing and denials management. Must have familiarity with data analysis and reporting and must be proficient with Microsoft Excel. The individual must exhibit an ability to participate in an environment that promotes staff development, productivity, satisfaction and efficiency. The individual must be customer service oriented (internal/external), exhibit strong communication skills - written and verbal, display an ability to multi-task, and use of general office equipment and systems are required.

Preferred Education - Bachelors

Preferred Education Field of Study - Business

Preferred Experience: 3 to 5 years denials management & analysis

Preferred Experience: 3 to 5 years hospital billing and claims follow-up

Required Experience: 1 to 2 years hospital billing and claims follow-up

Responsibilities

Population Specific Care No Direct Patient Care Denials Analysis & Resolution: 1) Conducts root-cause analysis of denials to determine where improveme ts within PFS or other departments may be necessary. 2) Collaborates with and provides support to PFS staff and management in appeals including, but not limited to, follow-up with departments where letters of medical necessity are required or retro-authorizations are needed, staff escalation of appeals requiring action or drafting letters to payors, follow-up with payors on denials, etc... 3) Researches contract terms/interpretation and compiles necessary supporting documentation for... For full info follow application link.

Equal Employment Opportunity