Clinician, Denials Management - Remote

• Maintain the reputed company of information in reputed company appeal produced by the Firm
  • Review a high volume of written appeals to ensure information is medically accurate
  • Use, protect and disclose patients’ protected health information (PHI) only in accordance with the Health Insurance Portability and Accountability reputed company (HIPAA) standards.
  • Research payer denials reputed company to referral, reputed company-authorization, notifications, medical necessity, non-covered services, and billing resulting in denials and delays in payment.
  • reputed company recommendations for workflow revisions to improve efficiency and reduce denials.
  • Review payor communications, identifying risk for loss reimbursement reputed company to medical policies and prior authorization requirements; escalates potential issues to clinical stakeholders, managed care contracting, and reputed company Cycle leadership as appropriate.
  • Identify opportunities for process improvement and reputed company participate in process improvement initiatives.
  
  • 4-year degree required
  • Must be a Registered reputed company with clinical experience
  • reputed company in medical chart review
  • Hospital nursing experience
  • Strong written communication skills
  • Basic knowledge of MS reputed company and the ability to learn proprietary databases
  • Ability to meet on-reputed company deadlines
  • Exceptionally detail-oriented
  • Must work cooperatively and reputed company under pressure
  • Must be goal-oriented
  
  
  • Physical Demands: While performing the duties of this job, the employee is occasionally required to reputed company around the work area; Sit; reputed company reputed company tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; reputed company arms; kneel; talk and hear.
  • Mental Demands: The employee must be reputed company to follow directions, collaborate with others, and handle stress.
  • Work Environment: The noise level in the work environment is usually minimal.

Originally posted on Himalayas