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Specialist-Denial I
Career Insights for Clinical Documentation Specialist
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Scorecard
Based on Tennessee data
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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
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.