Job Description

At  Cooper University Health Care , our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development.

Discover why Cooper University Health Care is the employer of choice in South Jersey.

Manages comprehensive Precertification integrity system and works toward goals and objectives for departmental denial management. Has a sound understanding of the payor policies related to denials and appeals process for all Institutes deemed within Healthcare Access scope. 

• Reviews and analyzes denial data for all Institutes within the scope of HCA to determine denial trends and developes remediation plans and/or workflow resolutions 

• Analyze CPT codes with payer policy change to ensure teams stay abreast to all relevant payer policy updates and pre authorization standards

• Collaborate with Revenue Cycle University to develop annual CLN’s and quality assurance processes for Insurance Specialists
• Develops and monitor EPIC reports and work queues to ensure timely response to denied cases and appeals and provides follow-up on cases until resolution has been achieved
• Presents denial metric driven information and workflow opportunities to Patient Access Leadership
• Develops and maintains positive, collaborative, supportive working relationships with all members of the organization

• Daily management of assigned Epic work queues to include DNB and retro authorization

• Assist in the on-going support of data collection, analyzation, and developing/implementing new strategies to ensure an effective authorization/scheduling process
• Participate in development of documents to drive quality improvement, including the design of quality monitoring forms and quality standards. Document and update process, procedures, guidelines, and training materials responsible for optimizing complex scheduling protocols, provider template build, and ad hoc and routine report generation.Serve as a Subject Matter Expert on all area’s within the scope of HCA Precertification.
• responsible for assisting in the design, build, validation, maintenance and support of provider templates for all outpatient scheduling departments.
• recognize and support the templates and fundamentally understand the impact on appointment availability, provider productivity, clinic work flow, clinic staffing, expense and revenue

Minimum 2 years management experience preferred in hospital/ambulatory patient access or related related business
Demonstrated ability to research, collect, and present information 
Strong computer skills; proficiency with Microsoft Office suite. Thourough understanding of ICD-10, CPT codes, HCPCS codes
Excellent interpersonal skills as well as superior writing skills. Deadline oriented; ability to work independently and in a team environment. Ability to manage multiple complex and concurrent projects.

Bachelors degree or equivalent experience

EPIC Schedule Strategy Badge to be obtained within 90 days

EPIC Cadence Proficiency to be obtained upon hire

Proficient in Microsoft Office (Excel, Powerpoint, Visio, Word

Healthcare experience preferred
Knowledge of Payor Portals & Policies
Knowledge of EPIC account, patient, and referral wqs

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