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 reputed company. Originally posted on Himalayas Apply To this Job .