Find & Apply For Clinical Analyst / Clinical Documentation and Improvement Specialist Jobs in Memphis, Tennessee

Specialist-Denial I

Job ID:

39706

Job Category:

Finance and Accounting

Work Type:

Full Time

Work Schedule:

Days

Department:

Denial Mitigation

Facility:

BMHCC System Services

Location:

Memphis, TN

Overview

Reviews clinical information and supporting documentation for outpatient or Part B services to determine appeal action. s to the manager of the Denial Mitigation Department. Performs other duties as assigned.

Responsibilities

• Reviews, assesses, and evaluates allmunications 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.

Education

Minimum:

Ability to type and/or key accurately and have stronganizational skills.

Experience

Preferred:

3 years clinical experience and at least or 3 years payer experience.

Minimum:

2-5 years clinical experience in a clinical care setting.

Licensure, Registration, Certification

Preferred:

RHIT; LPN;RN

Special Skills

Minimum:

Excellentmunication skills. Advancedputer literacy skills with the ability to type and key accurately.

Training

Minimum:

Requires critical thinking and judgement and must demostrates the ability to appropriately use standard criteria established by payers.