Find Jobs
Find Jobs Near You – Available Work in Your Location
Denial Mitigation-Specialist I
Career Insights for Clinical Documentation Specialist
See where this job fits in the broader career landscape. Knowing your career path helps you see what's possible from here.
Scorecard
Based on Tennessee data
Review key factors to help you decide if this role fits your goals. How is this calculated?
What they do
A Clinical Documentation Specialist works with information technology systems and applications in health care organizations. Assists clinicians and staff with technology and implementing new systems. Creates systems for organizing and interpreting data and information for clinical trials. Records and manages clinical information about patients, including health assessments and diagnoses, test results, treatments, and follow up care requirements. Reviews and maintains patient records.
$68,018 / year median in Tennessee
+1% projected growth
Job Description
Denial Mitigation-Specialist I
Job ID:
43022
Job Category:
Billing Claims and Revenue
Work Type:
Full Time
Work Schedule:
Days
Department:
Revenue Cycle
Facility:
BMHCC System Services
Location:
Memphis, TN
Overview
Job Summary
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.
Job 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.
Minimum Required Experience
3 years clinical experience and at least or 3 years payer experience.
Minimum Required Education
Ability to type and/or key accurately and have stronganizational skills.
Minimum Required Training
Requires critical thinking and judgement and must demonstrates the ability to appropriately use standard criteria established by payers.
Experienced in working in an outpatient or inpatient clinical setting.
Familiarity with electronic medical records and claims/practice management systems.
Minimum Required Special Skills
Excellentmunication skills.
Advancedputer literacy skills with the ability to type and key accurately.
Preferred/Desired Licensure
RN, LPN or RHIT preferred not required