• Specialist-Denial I

    Location US-TN-MEMPHIS
    Posted Date 1 month ago(5/9/2019 11:30 AM)
    Position Code
    5350
    Day Shift
    Yes
    Rotating Shift
    No
    Status
    PRN
    Department
    HS Denial Mitigation
  • Overview and Responsibilities

    Job Family:Clinical Documentation
    Job Summary: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.
    Department:HS DENIAL MITIGATION

    Qualifications

    DescriptionMinimum RequiredPreferred / Desired
    Experience  
    One or more of the following: - 5 years experience in healthcare (physician, or clinical/hospital setting). - 5 years payer environment performing activities such as auditing, patient billing, and/or denial management.2-5 years clinical experience in a clinical care setting.3 years clinical experience and at least or 3 years payer experience.
    Education  
    RN, LPN or RHIT preferred not requiredAbility to type and/or key accurately and have strong organizational skills. 
    Training  
    Experienced in working in an outpatient or inpatient clinical setting. Familiarity with electronic medical records and claims/practice management systems.Requires critical thinking and judgement and must demostrates the ability to appropriately use standard criteria established by payers. 
    Special Skills  
    Excellent interpersonal, communication, and writing skills. Advanced computer literacy skills. Strong analytical and problem solving skills with an ability to understand and troubleshoot interconnected data and denial processes.Excellent communication skills. Advanced computer literacy skills with the ability to type and key accurately. 
    Licensure  
    RN, LPN or RHIT preferred not required

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