Clinical Denials Audit & Analysis Specialist, Appeals & Denials, Baptist Metro Square
About The Position
Baptist Health is looking to add a Clinical Denials Audit & Analysis Specialist to join our Appeals and Denials Team at Baptist Metro Square. This is a Full-Time Days opportunity. As a Clinical Denials Audit & Analysis Specialist, you will be responsible for: Provides system support for Clinical Denials Audit and Analysis team. Works closely with the Denials and Appeals Nurses, Physician Advisors, and CDAA leadership to ensure denials are coordinated and escalations addresses, to ensure maximum reimbursement for the organization. Responsible for entry of and follow up on our concurrent (in-house) denials via the Epic Environment. Provides coordination for Medicare Discharge Appeals and coordinates with Utilization Management regarding outcomes. Schedules and provides clerical support to our Physician Advisors for Peer to Peer and payer escalation requests. Provides clerical support to the Denials and Appeals Nurses as required. Coordination of multiples requests and denials received via voicemail, fax, and department Outlook mailbox. This Clinical Denials Audit & Analysis Specialist will be located at Baptist Metro Square.
Requirements
- Entry of and follow up on concurrent (in-house) denials via the Epic Environment.
- Coordination for Medicare Discharge Appeals.
- Coordination with Utilization Management regarding outcomes.
- Scheduling and clerical support for Physician Advisors for Peer to Peer and payer escalation requests.
- Clerical support to the Denials and Appeals Nurses.
- Coordination of multiple requests and denials received via voicemail, fax, and department Outlook mailbox.
Responsibilities
- Provides system support for Clinical Denials Audit and Analysis team.
- Works closely with the Denials and Appeals Nurses, Physician Advisors, and CDAA leadership to ensure denials are coordinated and escalations addresses, to ensure maximum reimbursement for the organization.
- Responsible for entry of and follow up on our concurrent (in-house) denials via the Epic Environment.
- Provides coordination for Medicare Discharge Appeals and coordinates with Utilization Management regarding outcomes.
- Schedules and provides clerical support to our Physician Advisors for Peer to Peer and payer escalation requests.
- Provides clerical support to the Denials and Appeals Nurses as required.
- Coordination of multiples requests and denials received via voicemail, fax, and department Outlook mailbox.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
