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The Clinical Appeals and Denials Nurse reviews, monitors and analyzes denials received from payors (Medicare, Commercial and Third Party) and coordinates with Revenue Cycle team to seek proper reimbursement for those services rendered. This position also ensures medical necessity and documentation related issues are reviewed and coordinated with departments and medical staff.
The coordination with Case Management on denials/reduced payments associated with Inpatient/Observation will be monitored and analyzed to ensure physicians remain compliant with proper documentation and level of care assignments.
Flexible schedules to cover all shifts and weekends, as hospital needs demand.
Primary Duties
Audit and Appeal:
Other
Ambulatory Healthcare Services
$62k-76k (estimate)
06/02/2024
08/01/2024
arheart.com
LITTLE ROCK, AR
200 - 500
1997
Private
PAULO A RIBEIRO
$50M - $200M
Ambulatory Healthcare Services