Job Description: Reviews and appeals denials for all clinical services across the system. Researches various sources of information... charge audit/charge capture denials, charge correction, clinical validation, services deemed experimental, services denied...
proactively with administration, finance, revenue cycle, nursing, and ancillary management to ensure appropriate clinical business... of Epic edits; logic behind clinical department exception-based edits and Revenue Guardian workqueues for each service line...
, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist, and effectively... communicates with physicians and allied health personnel. Assists with writing compelling appeals to all DRG denials from outside...