*** Please note Beebe Healthcare Main Campus is located in Lewes, DE with other locations within a 22-mile radius in Sussex County, DE ***

Team Beebe! One Beebe! Beebe Healthcare is one of the largest employers throughout beautiful Sussex County, DE and we have exciting career opportunities available for qualified professionals.

Reimbursement Denials Manager - Business Services

The denial manager assumes responsibility and accountability for managing denials and reimbursement for third-party payers, as well as vendor denial management relations at Beebe Healthcare and Beebe Medical Group. This includes overseeing the denial process used by both in-house staff, affiliated denial management vendors, and continually working to identify opportunities for workflow improvements. The manager collaborates with the Revenue Cycle Directors and other team members to set departmental goals, measure process effectiveness and productivity and identify any need for updated policies and procedures. Reporting to the Revenue Integrity Director, the denial manager serves as a liaison to revenue cycle staff, clinical departments, payers, and patients by ensuring effective communication between all parties. In order to be considered for the position, please visit our website www.beebehealthcare.org to fill out an application.

Requirements:

Bachelor's degree or have 5 years of experience and are currently enrolled working on completing their Bachelor's degree.

Responsibilities:

• Maintains responsibility of the in-house and vendor denials management process and supervises compliant application of departmental and organizational policies, procedures, and standards.
• Tracks the status of all denial response efforts carried out by Beebe Healthcare denial management staff and vendors through overseeing and maintaining Beebe Healthcare's denial tracking tool.
• Maintains the internal denial tracking tool by extracting data for reports, training and educating staff on proper utilization, and updating software as needed.
• Provides direction and support to denial management staff by adhering to an established educational plan to ensure quality and productivity standards are met.
• Through collaboration with business office management, sustains appropriate staffing levels for the denial management team and coordinates overtime costs within the pre-determined budget.
• Gathers and assembles documentation related to denial trends and root causes for committee meetings and regular check-ins with Beebe Healthcare and vendor leadership.
• Meets with various revenue-generating departments to communicate root causes of denial (i.e., discrepancies in patient account information, documentation) and provides direction to mitigate denials in the future.
• Oversees the appeals process, which includes assessing, documenting, and/or guiding the resolution of denials processed by the denial management team and/or vendor.
• Acts as the primary liaison between the denial management vendor and the organization.
• Facilitates the assignment of appropriate accounts to the denial management vendor.
• Has primary responsibility for resolving problems and rectifying inefficiencies related to denial management vendor processes and relations.
• Manages contract negotiations and renegotiations with denial management vendor or vendor candidates.
• Serves as a resource for patients, vendor staff members, and revenue cycle personnel to expediently address and resolve questions and/or concerns.
• Executes excellent customer service and professionalism when interacting with staff, vendor representatives, payers, patients, and families to ensure all are treated with kindness and respect.
• Through leadership and by example, ensures that services are provided in accordance with state and federal regulations, organizational policy, and accreditation/compliance requirements.
• Demonstrates knowledge of Beebe Healthcare's safety policies and procedures by maintaining a safe work environment.
• Performs additional assignments and maintains current knowledge of the denial management field by independently following industry trends, as well as by completing any required ongoing training and instruction.
• Consults with department managers to help develop and implement policies and procedures for the purposes of reconciling charges posted in the billing system with other source information.
• Develops tools for the purposes of tracking and identifying potential areas of lost revenue.

Competencies and skills-Essential:

• Clear Communication Skills Both Written and Verbal
• Knowledge of Basic Computer Programs
• Able to Keep Confidential Information Regarding Patients, Team Members
• Able to Withstand Crisis Situations
• Has Skills to Provide Customer Service to Patients, Team Members and Visitors
• Experience or Completed Courses in Coding

Education-Essential:

• High school graduate or equivalent

Education-Nonessential:

• Bachelor's Degree in related field

Education equivalent experience - Nonessential:

• Bachelor's degree or have 5 years of experience and are currently enrolled working on completing their Bachelor's degree

We are experiencing tremendous growth which allows us to offer more services to more people in more locations. Beebe Healthcare offers you a healthy, supportive culture where you can truly flourish with an excellent patient-focused environment, and leading-edge technology. Working at Beebe provides a feeling of community and a place to call home away from home.

Join our team of heroes today to take advantage of our excellent benefits and compensation package.

Visit our website www.beebehealthcare.org/careers to apply and for more information

Phone: 302-645-3336

424 Savannah Road, Lewes, DE 19958

EOE

Job Type: Full-time

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Ability to commute/relocate:

• Lewes, DE 19958: Reliably commute or planning to relocate before starting work (Required)

Education:

• High school or equivalent (Preferred)

Experience:

• Medical billing: 1 year (Preferred)

Work Location: In person

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