Associates degree in business or health related degree or at least five (5) years especially in health insurance fields required.
Demonstrates ability to work independently and the ability to problem-solve with minimal supervision.
Ability to pull data from all of Munson Medical Center databases, tabulate and analyze data with minimal supervision.
Ability to act on insurance companies findings and initiate an appeal process.
Coordinates data/responses from all departments involved/mentioned in the appeals process.
Proven organizational skills and can work within strict time frames.
Effective in written and verbal communication skills.
1. Supports the mission statement of Munson Medical Center (MMC): Munson Medical Center is the core of a regional healthcare system. In partnership with physicians, we provide quality, compassionate, comprehensive and cost-effective services for improvement of the health of our patients and the communities we serve.
2. Embraces and supports the Continuous Quality Improvement (CQI) philosophy of Munson Medical Center: We are committed to the name of "Munson" meaning excellence. We will provide services that meet our customers' requirements every time.
3. Adheres to Exceptional Skills with People (ESP) House Rules at all times.
4. Design and implement communication methods between departments to assimilate data/information to be used in the appeal process.
5. Track outcomes and trend recurring denial patterns and communicate this finding to the department(s) involved.
6. Identify and facilitate appeal response with individual departments/clinical experts.
7. Will monitor, record and coordinate all follow-up requirements.
8. Communicate results of appeal with finance department, patient accounts and departments involved.
9. Summarize results of appeals every 6 months, i.e. protected revenue.
10. Performs all other duties as assigned.