Denial Coordinator at LSMA Management Inc

San Bernardino, California, United States -

Full Time

Start Date

Immediate

Expiry Date

02 Jul, 26

Salary

29.0

Posted On

03 Apr, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical terminology, Utilization management, Medical billing, Medical coding, CPT coding, HCPCS coding, ICD-10 coding, Electronic health record systems, Documentation accuracy, Communication skills, Problem-solving, Conflict resolution, Time management, Attention to detail, Data entry

Industry

Health and Human Services

Description

Description JOB SUMMARY The Denial Coordinator serves as a key liaison between patients, providers, health plans, and internal clinical leadership regarding utilization management denial and carve-out notifications in accordance with regulatory, health plan, CMS, and organizational standards. The Denial Coordinator ensures compliance, confidentiality, and effective communication while supporting audits, resolving inquiries, and promoting patient-centered service. Requirements MINIMUM & PREFERRED QUALIFICATIONS Education/Training Minimum: High school diploma or equivalent. Preferred: Coursework or training in healthcare administration, utilization management, or medical billing/coding. Experience Minimum: 2+ years of medical office or healthcare administrative experience. Preferred: 1+ years of Utilization Management experience. Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position. Certification(s) Typing certificate demonstrating a minimum of 45 WPM Skills, Knowledge & Abilities · Knowledge of medical terminology and healthcare administrative processes. · Working knowledge of CPT, HCPCS, and ICD-10 coding. · Strong written and verbal communication skills. · Ability to interpret benefit coverage and utilization management determinations. · High attention to detail with strong proofreading and documentation accuracy. · Ability to organize, prioritize, and manage multiple deadlines in a fast-paced environment. · Proficiency with general computer applications and electronic health record systems. · Ability to exercise sound judgment and make independent decisions within established guidelines. · Demonstrated professionalism, dependability, and service-oriented mindset. · Effective problem-solving and conflict-resolution skills. · Ability to work collaboratively and maintain positive interdepartmental relationships. PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS The physical, mental, and environmental demands described here are representative of those required to successfully perform the essential functions of this job. This position requires the ability to perform work primarily in a seated, office-based environment with frequent use of computers, phones, and other standard office equipment. The role involves occasional standing, walking, and light lifting (up to 20 pounds), as well as routine bending, reaching, and repetitive hand use for typing and documentation. The position also requires sustained concentration, attention to detail, effective time management, and the ability to exercise sound judgment while handling sensitive and confidential information. Work is performed in a medical or administrative office setting with minimal exposure to environmental hazards.

Responsibilities

The Denial Coordinator acts as a liaison between patients, providers, and health plans to manage utilization management denials and carve-out notifications. They ensure regulatory compliance, support audits, and resolve inquiries while maintaining accurate documentation.