mississippi baptist health systemsMemphis, TN
Specialist-Denial I
Specialist-Denial I
Specialist-Denial I
mississippi baptist health systemsMemphis, TN
10 days ago
Clinical Nurse SpecialistsHealth Information Technologists and Medical RegistrarsMedical Records Specialists
All Other Outpatient Care CentersOffices of Physicians (except Mental Health Specialists)All Other Miscellaneous Ambulatory Health Care Services
Apply for this role →Job Posting Reviews clinical information and supporting documentation for outpatient or Part B services to determine appeal action. Reports to the manager of the Denial Mitigation Department. Performs other duties as assigned.
Responsibilities:
Reviews, assesses, and evaluates all communications received in order to optimize reimbursement.
Evaluates clinical information and supportive documentation prior to initial appeal action in order to optimize reimbursement and utilization of resources.
Prepares response to appeal/request for information based on supporting clinical information in order to enhance reimbursement and maximize customer satisfaction.
Compiles, analyzes, and distributes necessary clinical and financial information and presents reports to other healthcare providers in order to improve performances, and increase awareness of resources consumed related to reimbursement.
Completes assigned goals.
Education:
Minimum: Ability to type and/or key accurately and have strong organizational skills. Experience
Preferred:
3 years clinical experience and at least or 3 years payer experience. Minimum: 2-5 years clinical experience in a clinical care setting. Licensure, Registration, Certification
Preferred: RHIT; LPN; RNSpecial Skills
Minimum: Excellent communication skills. Advanced computer literacy skills with the ability to type and key accurately.
Training:
Minimum: Requires critical thinking and judgement and must demonstrate the ability to appropriately use standard criteria established by payers.
Also on the board Same function, level within a rung
Level
Senior
Location
Memphis, TN
Occupation
Clinical Nurse Specialists
Industry
All Other Outpatient Care Centers
Posted
10 days ago