SPECIALIST-DENIAL II

US-TN-MEMPHIS
2 months ago
Position Code
23504681
Day Shift
Yes
Night Shift
No
Rotating Shift
No
Evenings
No
Status
Regular Full-Time
Department
HS DENIAL MITIGATION

Overview and Responsibilities

Position Code:23504681
Position Title:Denial Specialist II  
Job Family:Clinical Documentation
Job Summary:Reviews clinical information and supporting documentation for acute care inpatient Part A 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  
RN with 5 years experience working in acute care hospital setting. Preference given for additional 3-5 years payer environment performing activities such as auditing, patient billing, and or / denial management or additional 3-5-- years case management experience.RN, 5 years clinical experience in a clinical care setting.Five years clinical experience and 3-5 years case management or denial management experience.
Education  
RN RequiredAbility to type and/or key accurately and have strong organizational skills. 
Training  
Nursing, Case Management or Denial Management 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  
RNRNCCM , CCS , RN
Reporting Relationships
Does this position formally supervise employees?No
If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.




 

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