Clinical Denials And Appeals Professional

The client is looking at hiring a Clinical Denials And Appeals Professional for their team at Guadalajara, Mexico. Education : Doctorate in Medicine. RESPONSIBILITIES : Review documentation, activity summary and correspondence to obtain notes related to the denial. Review claim and billing history to isolate any denials related to coding, billing, timely filing, missing or incorrect information. Work on medical necessity and identify the root cause of the denial. Review medical records and obtain necessary information to support medical necessity. Review for additional information such as insurance card, face sheet, detailed bill, EOB, UB04, auth approval and denial letter. Compose an appeal letter if appealing the denial. COMPETENCIES, SKILLS AND OTHERREQUISITES : Unflinching integrity and personal work ethics Self-starter who strives for self and team excellence Flair for client satisfaction Attention to detail and concern for accuracy Excellent time management skills and multi-tasking ability Excellent team player Compliant to rules and regulations

Creado: Jue, 01 de Ene de 1970