Benefits
Comprehensive Health Coverage – Medical, dental, and vision plans to keep you
and your family healthy.
Future Security: 401(k) with matching
Student Loan Support – Up to $10,000 repayment assistance, because we invest
in your future.
Educational Tuition Assistance
Competitive Pay & Full Benefits – A salary and package designed to reward
your expertise and dedication.
Job Summary
The Denials & Appeals Coordinator is responsible for managing, tracking, and
resolving denials and appeals to ensure timely reimbursement. This role requires
in-depth knowledge of payer guidelines, systems, and requirements to navigate
complex denial cases effectively, assist in issue resolution, and help identify
trends that can improve claim outcomes.
Essential Functions
Monitors assigned queues and duties across various systems (such as, Artiva,
HMS, Hyland, BARRT) to ensure all follow-up dates are current.
Analyzes denials to determine appropriate actions, completes appeals, or
routes cases for clinical appeals as needed.
Files and monitors appeals to resolve payer denials, documenting all activity
accurately and maintaining logs, account notes, and system records.
Maintains an up-to-date understanding of payer guidelines and requirements
related to denials and appeals.
Processes BARRT requests, reviews RAC/Government Audit accounts, and
completes necessary rebills and adjustments.
Identifies trends in denials to suggest improvements and reduce future claim
issues, providing data for denial and appeal trends as needed.
Performs other duties as assigned.
Maintains regular and reliable attendance.
Complies with all policies and standards.
Qualifications
H.S. Diploma or GED required
Associate Degree or higher in Health Information Management preferred
1-3 years of experience in medical billing, revenue cycle, or claims denials
and appeals processing required
Prior experience with revenue cycle processes in a hospital or physician
office setting required
Knowledge, Skills and Abilities
Strong knowledge of payer guidelines, medical billing practices, and appeal
processes.
Proficiency in relevant software and claim management systems, such as
Artiva, HMS, Hyland, and BARRT.
Excellent analytical skills for reviewing denial trends and suggesting
improvements.
Strong verbal and written communication skills to interact with payers and
internal departments.
Ability to prioritize tasks effectively and manage time in a fast-paced
environment.
Licenses and Certifications
Certified Revenue Cycle Specialist (CRCS) - AAHAM preferred
The Payment Compliance and Contract Management (PCCM) team plays a critical role
in ensuring that payments are made according to contractual agreements and
regulatory requirements. The team oversees the full contract lifecycle, focusing
on analyzing reimbursement discrepancies, improving revenue cycle processes, and
ensuring compliance with contract terms to support financial accuracy and
operational efficiency.
Community Health Systems is one of the nation’s leading healthcare providers.
Developing and operating healthcare delivery systems in 40 distinct markets
across 15 states, CHS is committed to helping people get well and live
healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites
of care, including physician practices, urgent care centers, freestanding
emergency departments, occupational medicine clinics, imaging centers, cancer
centers and ambulatory surgery centers.