Coordinator Clinical Denials - Halifax Regional - Roanoke Rapids, NC

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938815

Full-Time

Regular

Vidant Health

About Vidant Halifax Hospital

Halifax Regional Medical Center is a Joint Commission-accredited, 204-bed acute bed facility where residents of Halifax, Northampton and Warren counties in North Carolina and Mecklenburg, Brunswick and Greensville in Virginia receive a wide range of health services close to home. Halifax Regional Medical Center’s team of more than 60 providers and 850 employees represent most medical specialties. In addition to 24-hour emergency care, we also offer intensive care, medical, surgical, orthopedic, behavioral health, rehabilitation and therapy services; a cardiac catheterization lab; and outpatient clinics. Our partnership with Vidant Health connects the communities we serve with broader access to various levels of care, enabling us to further customize treatment based on a patient’s unique needs.


 

Position Summary

Coordinates the appeals process, data entry, and analysis for governmental and commercial denials across Vidant Health. Liaison between internal and external parties to ensure timelines are met with regard to appeal preparation and submission. Monitors progression of appealed cases through final appeal process. Acts as software expert to ensure automation enhances the efficiency of the appeals process.

Minimum Requirements

  • Business or Computer Sciences major
  • Progressive experience in utilization management and appeal and denial management
  • Database management, data entry, process management, familiarity with appeals management principles; clinical setting preferred
  • Associate Degree or higher
  • Five to seven years related experience

General Statement

It is the goal of Vidant Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer.   Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.

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