Specialist-Denial Mitigation I PRN

Baptist Memorial Health Care • Memphis, TN

76d

About The Position

The position involves reviewing clinical information and supporting documentation for outpatient or Part B services to determine appeal action. The role reports to the manager of the Denial Mitigation Department and includes performing other duties as assigned.

Requirements

• Minimum: Ability to type and/or key accurately and have strong organizational skills.
• Minimum: 2-5 years clinical experience in a clinical care setting.
• Minimum: Excellent communication skills.
• Minimum: Advanced computer literacy skills with the ability to type and key accurately.
• Minimum: Requires critical thinking and judgement and must demonstrate the ability to appropriately use standard criteria established by payers.

Nice To Haves

• Preferred: 3 years clinical experience and at least 3 years payer experience.
• Preferred: RHIT; LPN; RN.

Responsibilities

• Reviews, assesses, and evaluates all communications received in order to optimize reimbursement.
• Evaluates clinical information and supportive documentation prior to initial appeal action in order to optimize reimbursement and utilization of resources.
• Prepares response to appeal/request for information based on supporting clinical information in order to enhance reimbursement and maximize customer satisfaction.
• Compiles, analyzes, and distributes necessary clinical and financial information and presents reports to other healthcare providers in order to improve performances, and increase awareness of resources consumed related to reimbursement.
• Completes assigned goals.

What This Job Offers

• Industry: Religious, Grantmaking, Civic, Professional, and Similar Organizations
• Number of Employees: 5,001-10,000 employees