You will be responsible for reviewing clinical documentation, analyzing payer denials, and writing appeal letters to overturn inappropriate denials.
This role requires strong analytical, clinical, and communication skills, as well as a solid understanding of insurance guidelines and medical necessity criteria. […]
Review clinical records and insurance denial letters to determine the validity and potential for appeal.
Prepare comprehensive and persuasive appeals letters in alignment with payer policies, medical guidelines, and regulatory standards.
Collaborate with physicians, case managers, coders...