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West Virginia University Hospitals, Inc. Clinical Denial Specialist (JR24-40780) in Morgantown, West Virginia

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This position provides assistance to the Utilization Review and Denial Management team through computer skills, coordination, non-clinical appeal writing, and clerical assistance.

MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High School diploma or equivalent. EXPERIENCE: 1. Two (2) years training or related experience. One (1) year of administrative support training may substitute for experience.

PREFERREDQUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Associate Degree in related field. EXPERIENCE: 1. Experience with hospital billing. 2. Five (5) years of experience with Microsoft suite of technologies.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

  1. Completes non-clinical appeal writing and coordination as directed by leadership.
  2. Organizes and manages clinical appeal letter submissions via mail or other portals.
  3. Assists with payroll management as directed.
  4. Maintains clinical denial tracking and logging through Microsoft or assigned computer programs.
  5. Coordinates or assists in the preparation of administrative reports, statistical tables, requisitions, and other data gathering for review by or signature of the Director or Manager.
  6. Coordinates, schedules, and reserves meetings as directed.
  7. Coordinates reimbursement expense reports as directed by leadership.
  8. Manages and distributes incoming mail in a timely manner and coordinates outgoing mail.
  9. Coordinates the duplication and collection of materials on a regular basis, filing masters or copies as appropriate.
  10. Composes and types correspondence such as letters, memoranda, policies, procedures, reports, etc. from notes, drafts in an accurate, neat and timely manner as assigned and proof reads for accuracy prior to submittal or distribution.
  11. Accurately records and transcribes meeting minutes as directed. Minutes are completed within a timely manner and stored in an accessible location.
  12. Maintains appropriate records and establishes filing system to ensure the expeditious retrieval so that Director, Manager and staff can accomplish their responsibilities.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable... For full info follow application link.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. Please view Equal Employment Opportunity Posters provided by OFCCP here. The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

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