Work where every moment mattersEvery day more than Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the system Position SummaryThe Denial Coordinator will serve as the central person for processing all Diagnostic Reimbursement Group DRG validation denials This position is responsible for ensuring the timely and accurate processing of DRG validation denials managing documentation tracking information requests and ensuring adherence to appeal deadlines The Denial Coordinator will also work in collaboration with the HIM Audit Coordinator Position ResponsibilitiesKey areas of responsibilitymiddot Coordinate initiate and respond to all DRG denial requests through resolutionmiddot Monitor and maintain status of all appeal levels ensuring timely follow up and closuremiddot Track denial activity and appeal outcomes to identify trends and opportunities for improvementmiddot Conduct account research and determine appropriate appeal strategies escalating as neededmiddot Collaborate with coding CDI physicians and other stakeholders to investigate and resolve denialsmiddot Ensure compliance with payer deadlines appeal timelines and contract termsmiddot Enter and maintain accurate denial and appeal data in the designated tracking systemmiddot Prepare and distribute reports on denial activity and appeal outcomes to inform stakeholdersmiddot Run ad hoc reports and analyze DRG validation denial trends as requestedCommunicationmiddot Serve as liaison between the organization payers and vendors to resolve claims and clarify guidelinesmiddot Communicate effectively across departments to support appeal efforts and obtain documentationmiddot Support denials management team with delegated tasks and maintenance of documentation toolsOthermiddot Evaluate and improve denial management processes in response to audit findings or operational needsmiddot Assist teams in developing tools and workflows to reduce denials and improve appeal outcomesmiddot Ensure adherence to revenue cycle KPIs and productivity standardsmiddot Maintain compliance with AHIMArsquos Standards of Ethical Coding and official coding guidelinesmiddot Mentor new and current team membersmiddot Perform other related duties as assigned Working RelationshipThis Job Reports To Job Title HIM Manager Coding Quality and EducationWork where every moment mattersEvery day more than Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the system Position SummaryThe Denial Coordinator will serve as the central person for processing all Diagnostic Reimbursement Group DRG validation denials This position is responsible for ensuring the timely and accurate processing of DRG validation denials managing documentation tracking information requests and ensuring adherence to appeal deadlines The Denial Coordinator will also work in collaboration with the HIM Audit Coordinator Position ResponsibilitiesKey areas of responsibilitymiddot Coordinate initiate and respond to all DRG denial requests through resolutionmiddot Monitor and maintain status of all appeal levels ensuring timely follow up and closuremiddot Track denial activity and appeal outcomes to identify trends and opportunities for improvementmiddot Conduct account research and determine appropriate appeal strategies escalating as neededmiddot Collaborate with coding CDI physicians and other stakeholders to investigate and resolve denialsmiddot Ensure compliance with payer deadlines appeal timelines and contract termsmiddot Enter and maintain accurate denial and appeal data in the designated tracking systemmiddot Prepare and distribute reports on denial activity and appeal outcomes to inform stakeholdersmiddot Run ad hoc reports and analyze DRG validation denial trends as requestedCommunicationmiddot Serve as liaison between the organization payers and vendors to resolve claims and clarify guidelinesmiddot Communicate effectively across departments to support appeal efforts and obtain documentationmiddot Support denials management team with delegated tasks and maintenance of documentation toolsOthermiddot Evaluate and improve denial management processes in response to audit findings or operational needsmiddot Assist teams in developing tools and workflows to reduce denials and improve appeal outcomesmiddot Ensure adherence to revenue cycle KPIs and productivity standardsmiddot Maintain compliance with AHIMArsquos Standards of Ethical Coding and official coding guidelinesmiddot Mentor new and current team membersmiddot Perform other related duties as assigned Working RelationshipThis Job Reports To Job Title HIM Manager Coding Quality and EducationEducationmiddot Minimum High School Diploma or Equivalent Requiredmiddot Preferredo Associate degree or equivalentExperiencemiddot Minimum Two yearsrsquo experience within healthcare revenue cycle or other healthcare field performing a variety of organizational administrative or process improvement functionsmiddot Preferred Three years of progressive on the job DRG denials experience within healthcare revenue cycle or other healthcare field performing DRG denial review auditing or Clinical Documentation reviewsLicensure Certification Registrationmiddot Preferred A Certified Professional Coder with a Registered Health Information Technician RHIT Registered Health Information Administrator RHIA Certified Coding Specialist CCS andor Certified Procedural Coder CPCLanguage Skillsmiddot Strong written and verbal communication skillsKnowledge Skills and Ability Requirementsmiddot Comprehensive understanding of ICD CM diagnosis and ICD PCSmiddot Familiarity with payer guidelines healthcare billing codes and medical terminologymiddot Strong organizational skills with a high level of accuracy and attention to detailmiddot Strong interpersonal skillsmiddot Excellent communication and collaboration abilitiesmiddot Strong problem solving analytical and critical thinking skillsmiddot Strong presentation skills with the ability to feel comfortable in presentingdefending audit logic to client and key stakeholdersmiddot Experience working with cross functional departments to research and resolve issues using innovative solutionsmiddot Proficient with spreadsheets and database applicationsmiddot Knowledge of the audit tracking systemmiddot Ability to work independently We take great care of careers With locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment Educationmiddot Minimum High School Diploma or Equivalent Requiredmiddot Preferredo Associate degree or equivalentExperiencemiddot Minimum Two yearsrsquo experience within healthcare revenue cycle or other healthcare field performing a variety of organizational administrative or process improvement functionsmiddot Preferred Three years of progressive on the job DRG denials experience within healthcare revenue cycle or other healthcare field performing DRG denial review auditing or Clinical Documentation reviewsLicensure Certification Registrationmiddot Preferred A Certified Professional Coder with a Registered Health Information Technician RHIT Registered Health Information Administrator RHIA Certified Coding Specialist CCS andor Certified Procedural Coder CPCLanguage Skillsmiddot Strong written and verbal communication skillsKnowledge Skills and Ability Requirementsmiddot Comprehensive understanding of ICD CM diagnosis and ICD PCSmiddot Familiarity with payer guidelines healthcare billing codes and medical terminologymiddot Strong organizational skills with a high level of accuracy and attention to detailmiddot Strong interpersonal skillsmiddot Excellent communication and collaboration abilitiesmiddot Strong problem solving analytical and critical thinking skillsmiddot Strong presentation skills with the ability to feel comfortable in presentingdefending audit logic to client and key stakeholdersmiddot Experience working with cross functional departments to research and resolve issues using innovative solutionsmiddot Proficient with spreadsheets and database applicationsmiddot Knowledge of the audit tracking systemmiddot Ability to work independently We take great care of careers With locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment