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Clinical Denial Specialist
2 weeks ago
Access Healthcare Services is seeking an experienced Clinical Denial Specialist to join our growing team. In this role, you'll be responsible for performing advanced level work related to clinical denial and utilization management. This includes managing medical denials through comprehensive reviews of clinical documentation, handling audit/compliance responsibilities, and resolving charge problems to ensure accurate billing.
We're looking for a Registered Nurse with an active license and BPO experience. If you're passionate about delivering high-quality patient care and possess excellent communication skills, we'd love to hear from you
In this position, you'll actively engage with patients, healthcare professionals, and internal stakeholders to ensure seamless communication and effective resolution of medical denials. Your expertise will play a critical role in maintaining accurate and complete billing practices, ensuring timely reimbursement, and preventing revenue loss.
- Key Responsibilities:
- Manage medical denials
- Resolve charge problems
- Communicate denial/appeal activity
- Engage with patients and healthcare professionals
- Maintain accurate billing practices
