Denial Prevention Coordinator
The Denial Prevention Coordinator (DPC) is a key position in the patient financial experience by coordinating insurance benefits, insurance authorization and notifications. This will include, but not limited to, verification and/or re-verification of benefits, verification or initiation of notification and authorization. The position will have an acute understanding of payer guidelines with respect to eligibility, notification and authorization requirements. The role will serve as a subject matter expert for resolution and education. The DPC will coordinate with the respective departments, offices or physicians, as appropriate, to secure an authorization. Additionally, the position will trend and assist in resolution of deferred visits due to lack of authorization. The position will have a broad understanding of how insurance verification, notification and authorization processes impact the overall performance of the revenue cycle.
- Coordinating insurance benefits, insurance authorization and notifications Identifies charging, coding, or clinical documentation issues and works with respective departments to resolve issues and notify appropriate leadership.
- Serve as a subject matter expert for resolution and education
- Coordinate with the respective departments, offices or physicians, as appropriate, to secure an authorization
- Trend and assist in resolution of deferred visits due to lack of authorization
- Reduce authorization denials by identifying, trending and assisting in resolving authorization denials.
Required Knowledge and Skills
- Excellent communication skills both verbal and written.
- Good interpersonal skills.
- Able to establish good customer relationships with trust and respect.
Education and Experience
- Education: High School Diploma required, Bachelor’s degree preferred
- Experience (Type & Length): 5-10 years’ related experience required.
- Certification/Licensure: N/A
- Software/Hardware: Navigation and edit resolution through various Web based systems, Ability to use email, Excel, Word.