1.0 FTE Full time Day - 08 Hour R2655658 Remote USA 108530009 Rev Cycle Denials Other
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Day - 08 Hour (United States of America)
This is a Stanford Health Care job.
A Brief Overview
The Government Audit and Appeals Program Coordinator supports the department with operations and management of the appeals process. The Program Coordinator will work closely with the Government Audit and Appeal Specialists, Sr. Manager of Government Audit and Appeal, Patient Financial Services (PFS) department, Professional Billing Office (PBO), Health Information Management Services (HIMS), payors and reviewer entities to ensure a timely and effective appeals process is maintained.
The Government Audit and Appeals Program Coordinator reports to the Sr. Manager of Government Audit and Appeals.
Locations
Stanford Health Care
What you will do
Adheres to Stanford Health Care’s organization competencies and Code of Conduct.
Manages all appeals correspondences by systematically tracking records requests, findings letters and stages of appeals throughout the course of the appeals process within tracking tool/application.
Triage and monitor EPIC work queues and team email for payor denials and disseminates to appropriate department according to content.
Responsible for the maintenance of all routine clerical operations and communications.
Self-sufficient individual who can problem-solve, prioritize and facilitate complex projects in the course of their daily activities.
Follow up with payors and/or reviewing entities to inquire about the status of appeals, ensuring timely updates and addressing any additional information or documentation they may require facilitating the review process.
Internal coordination in assisting with HIMS follow up on tracking information for submitted documentation such as medical records and appeals to payors and reviewing entities.
Coordinate and assist with the timely filing of government appeals by facilitating communication among team members, ensuring all necessary documentation and/or appeals are submitted within required deadlines, and monitoring the progress of each appeal to address any issues that may arise promptly.
Provide data analytics on appeals outcomes to gain valuable insights into the effectiveness of their appeals process. Summarize information for internal or external constituents. Prepare and organize documents, reports, and presentations for meetings and events.
Manage team calendars scheduling meetings and transcribe minutes with action items.
Education Qualifications
Experience Qualifications
Three-five (3-5) years equivalent combination of coding, auditing, or program coordination in a hospital, large healthcare system or major corporation.
Required Knowledge, Skills and Abilities
Ability to support the effectiveness and continuity of the Government Audit and Appeal program.
Organized with strong project management skills and effective in influencing others without having direct lines of authority.
Ability to manage and prioritize multiple tasks; ability to meet deadlines and follow through on assigned duties; ability to work well under pressure; ability to maintain a service-oriented approach.
Excellent verbal and written communication skills.
Analytical and critical thinking skills.
Strong computer skills, including basic keyboarding skills, and Microsoft Office (including Word, Excel, PowerPoint, and Outlook) proficiency. Microsoft Visio proficiency, preferred.
Knowledge and understanding of general state and federal requirements pertaining to patient privacy and confidentiality.
Able to maintain confidentiality of sensitive and confidential information in accordance with appliable laws, policies and rules.
Demonstrates effective communication and presentation skills.
Ability to adapt to changing priorities and shifts in denials and appeals activity while maintaining high standards of accuracy and compliance.
Licenses and Certifications
CCS - Certified Coding Specialist preferred .
CIC - Certified Inpatient Coder preferred .
RHIT - Registered Health Information Technician preferred .
RHIA - Registered Health Information Administrator preferred .
COC - Certified Outpatient Coder preferred .
These principles apply to ALL employees:
SHC Commitment to Providing an Exceptional Patient & Family Experience
Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.
You will do this by executing against our three experience pillars, from the patient and family’s perspective:
Know Me: Anticipate my needs and status to deliver effective care
Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
Coordinate for Me: Own the complexity of my care through coordination
Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.
Base Pay Scale: Generally starting at $41.68 - $54.19 per hour
The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.
