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...
via mail, fax, or Federal Express using the denials management tool. Identifies system loading discrepancies and refers... denial management correspondence to understand reasons for claim denials and develops strategies to address them. Handles...
proactively with administration, finance, revenue cycle, nursing, and ancillary management to ensure appropriate clinical business... department personnel. Reviews and updates existing training documents related to charge capture. Works with PFS and Denials...
communicates with physicians and allied health personnel. Assists with writing compelling appeals to all DRG denials from outside... continuity and optimal revenue cycle management. The expertise and experiences you’ll need to succeed: QUALIFICATION...