Denials Specialist

Job Number 47566
Posted 7/13/2017
Account Eastern Maine Medical Center
Location EMMC - Cumberland Place, ME 04401
Schedule Regular Full-time
Shift Day
Hours 8:00 am - 4:30 pm
Job Details Position Summary
The Denials Specialist will, under the direction of the Manager, Financial Analysis and Clinical Effectiveness, will assist in identifying and implementing process improvements in an effort to operate a "best in class" revenue cycle. This position serves in a key role to improve the overall effectiveness of revenue cycle policy, practices and technology platforms for EMMC. The Denials Specialist is an analytical and process improvement role with a primary focus of working on revenue cycle tasks directed by department leaders with the purpose of improving revenue cycle process outcomes. This position requires competency in revenue cycle, financial, business, clinical or other analytical skills with a focus on key performance metrics. The primary responsibility of this role is to assist in data and information needs to show both gap in performance as well as measurement of initiatives and tactics. The Specialist will serve as a resource for teams working on major, complex performance improvement efforts that affect multiple departments and clinical practice revenue cycle protocols throughout EMMC. The Denials Specialist will be involved with: gathering requirements, analyzing findings, recommending solutions, implementing new and improved processes and recommending ongoing controls and protocols as well as monitoring the existing processes. Effectiveness of this position shall be measured in terms of assisting teams to achieve financial and other tactic, high quality output, and customer satisfaction.

Bachelor's degree required or 8 years progressive relevant knowledge toward mastery in the field accepted in lieu of a Bachelor's Degree.

Other Skills Required
Certified Revenue Cycle Professional certificate within three years of employment. Must be available to provide own means of transportation as needed to meet business travel needs.

Working Environment
Traveling 15-20%; this job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the role.

Physical Requirements
Light to medium carrying and lifting up to 30 lbs. with some bending, straight pulling/pushing, reaching in all directions, stooping, walking long distances, standing, sitting, manual dexterity and ability to use both hands in a repetitive manner. Requires a stationary position for 80% of the work day. Dexterity with use of computer keyboard and writing implements. Must be able to work in an open office environment and possesses visual and hearing acuity necessary to discern information form the telephone, computer, printed forms, written and oral instructions from coworkers and others.

Equal Opportunity Employment
We are an equal opportunity, affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sexual orientation, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.