SHSMD Career Center

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