Remote Job: Denials Coordinator, Healthcare Performance Improvement – Managed Services (CA Remote)

Huron

  • San Francisco, CA


  • Permanent

  • Full-time

job postings on our Careers page:

Category: Healthcare Consulting

Opportunity Type: Experienced

Country: United States

Office Locations: San Diego – CA ; San Francisco – CA

The_Opportunity

Huron helps its clients drive growth, enhance performance and sustain

leadership in the markets they serve. We help healthcare organizations build

innovation capabilities and accelerate key growth initiatives, enabling

organizations to own the future, instead of being disrupted by it. Together, we

empower clients to create sustainable growth, optimize internal processes and

deliver better consumer outcomes.

Health systems, hospitals and medical clinics are under immense pressure to

improve clinical outcomes and reduce the cost of providing patient care.

Investing in new partnerships, clinical services and technology is not enough

to create meaningful and substantive change. To succeed long-term, healthcare

organizations must empower leaders, clinicians, employees, affiliates and

communities to build cultures that foster innovation to achieve the best

outcomes for patients.

Joining the Huron team means you ll help our clients stabilize their busine

operations today and create tomorrow s growth by implementing revenue

enhancement and cost containment programs, upgrading technology systems,

creating stronger leaders and improving outcomes for patients.

Join our team as the expert you are now and create your future.

Position_Summary

Adventist Health s Revenue Cycle Operations are jointly operated by Huron

Healthcare and Adventist Health. Huron manages the operations and provides the

Revenue Cycle leadership (managers and above are employed by Huron), while

Revenue Cycle associates are employed by Adventist. Market leaders and

hospital, clinic, and physician leadership across Adventist s 21 hospitals

and 300+ clinics, are key stakeholders for the Revenue Cycle Operations and a

critical factor to ongoing Revenue Cycle success.

As leaders within a large health system, Denials Coordinators are responsible

for understanding and analyzing denials and write-offs, identifying root cause

and prevention steps, and communicating information to other key stakeholders.

Denials Coordinators are also responsible for maintaining and distributing all

relevant denials and write-off prevention material. They will also act as the

liaison between Revenue Cycle departments and market leadership. Denials

Coordinators will be responsible for coordinating denials prevention efforts

across key stakeholders and monitoring progress toward denials resolution. As

needed, they will be responsible for working with IT to resolve denials with a

technical root cause.

The function s oversight encompasses both inpatient and outpatient denials

and write-offs so the Denials Coordinator should be knowledgeable of both

environments. Reporting systems will be provided to assist with denials

analysis. Denials Coordinators are responsible for assuming ownership of these

systems alongside the creation and distribution of denials report sets.

Duties_&_Responsibilities

  • Lead and facilitate Denials Prevention and Management Task Force

meetings. Ensure active attendance, participation, and accountability of

individuals taking assigned next steps. Oversee maintenance of action log

with open and recently resolved issues to ensure regular progress is

documented. Seek to continually enhance and improve the denial prevention

meeting structure.

  • Review monthly denial report sets to facilitate ongoing denial

conversations. Interpret the data in order to identify emerging trends

and insert commentary summaries.

  • Leverage denial data results to coordinate closely with Adventist Revenue

Cycle and Department leaders to identify process improvement

opportunities to address denial root causes. Assist with the process

improvement implementation, project planning requirements, training, and

post implementation monitoring.

  • Hold individuals across various departments accountable to addressing

root cause issues and meeting identified goals and targets

  • Ongoing coordination with Huron denial analytics resources in order to:
  • Review identified denials and write-off issues, confirm root cause

analysis findings, and complete additional research on specific process

breakdowns as required

  • Quantify recently denial process improvement activities for financial

impact and benefit

  • Update denial-related goals on an annual basis to ensure goals remain

relevant to Adventist and align with industry best practices

Required_Skills

  • Knowledge of accounting systems and insurance issues, healthcare industry

issues and trends, legal issues in field of expertise, required third

party and governmental guidelines, and work processing

  • Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and

Excel

  • Ability to think strategically about priorities and problem solving
  • Demonstrated leadership skills and vision
  • Ability to define initiatives and drive to resolution
  • Excellent communication skills both oral and written – and an abili

to relay information in an effective manner

  • Excellent conflict-resolution and customer service skills
  • Strong understanding of Patient Accounting processes in a hospital

environment

  • Ability to develop detailed understanding of Department-specific

processes

  • Ability to report key improvement data, and show progress towards goals
  • Skills in networking with colleagues at all levels (staff, managers,

executives)

  • Ability to analyze financial information to determine impact of possible

changes

  • Knowledge of:
  • Hospital and professional billing processes and reimbursement
  • The appeals process for Medicare, Medicaid, and Medi-Cal
  • Third-party contracts
  • Insurance protocols, delay tactics, systems, and workflows
  • ERISA guidelines for denials and appeals
  • Federal and state regulations related to denials and appeals

Qualifications

  • Requires Bachelor s degree (Business Administration, Accounting,

Finance, Information Technology, or Health Administration preferred) and

3+ years of experience within revenue cycle operations, revenue metrics

and analytics, and revenue management or equivalent combination of

education and experience

  • 1+ years of leadership experience in a multi-facility, integrated health

care delivery system or consulting experience preferred

  • Able to travel to various Adventist Health sites (30% to 40%) as needed

About_Huron

At Huron, we re redefining what a consulting organization can be. We go

beyond advice to deliver results that last. We inherit our client s

challenges as if they were our own. We help them transform for the future. We

advocate. We make a difference. And we intelligently, passionately,

relentlessly do great work together.

Are you the kind of person who stands ready to jump in, roll up your sleeves

and transform ideas into action? Then come discover Huron.

Whether you have years of experience or come right out of college, we invite

you to explore our many opportunities. Find out how you can use your talents

and develop your skills to make an impact immediately. Learn about how our

culture and values provide you with the kind of environment that invites new

ideas and innovation. Come see how we collaborate with each other in a culture

of learning, coaching, diversity and inclusion. And hear about our unwavering

commitment to make a difference in partnership with our clients, shareholders,

communities and colleagues.

Huron Consulting Group offers a competitive compensation and benefits package

including medical, dental, and vision coverage to employees and dependents; a

401(k) plan with a generous employer match; an employee stock purchase plan; a

generous Paid Time Off policy; and paid parental leave and adoption assistance.

Our Wellness Program supports employee total well-being by providing free

annual health screenings and coaching, bank at work, and on-site workshops, as

well as ongoing programs recognizing major events in the lives of our employees

throughout the year. All benefits and programs are subject to applicable

eligibility requirements.

Huron is fully committed to providing equal employment opportunity to job

applicants and employees in recruitment, hiring, employment, compensation,

benefits, promotions, transfers, training, and all other terms and conditions

of employment. Huron will not discriminate on the basis of age, race, color,

gender, marital status, sexual orientation, gender identity, pregnancy,

national origin, religion, veteran status, physical or mental disability,

genetic information, creed, citizenship or any other status protected by laws

or regulations in the locations where we do business. We endeavor to maintain a

drug-free workplace. Huron will consider qualified applications with criminal

history in accordance with applicable laws.

Li

Yes

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