FACILITY DENIALS/APPEALS SPECIALIST
MCBRIDE ORTHOPEDIC HOSPITAL•Oklahoma City, OK
6d•Onsite
About The Position
The Facility Denials/Appeals Specialist reviews and investigates facility denials, underpayment, audit and recoupment requests. Gathers information and researches payer policies and is responsible for all facility appeals and medical reviews, while ensuring compliance with organization standards and regulatory requirements.
Requirements
- High school diploma and equivalent GED
- two to three years of Medical Billing
- Facility Billing experience and knowledge of ICD-10-CM and ICD-10-PCS
- an individual must have intermediate computer skills
Nice To Haves
- two to three years of experience in Hospital Facility Denials
- CPC Certified
- Experience with Clinical Documentation Improvement (CDI) and Clinical Quality Measures
Responsibilities
- reviews and investigates facility denials
- reviews underpayment, audit and recoupment requests
- gathers information and researches payer policies
- responsible for all facility appeals and medical reviews
- ensuring compliance with organization standards and regulatory requirements
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
Number of Employees
501-1,000 employees
