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Appeals and Denials Nurse
Overview
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Appeals and Denials Professional Needed
RN or FMG: CDIP, CCDS, CCS and/or ICD-10 Certification or Trainer designation
Must have strong background in CDI and have experience with inpatient appeals letters.
- Reviews and completes continuous daily work queue volume of denials.
- Most, if not all denials will be from post-acute care facilities. (mostly behavioral health patients with medical needs)
- Analyzes work queues and other system report and identifies denial/non-payment trends
- Maintains open communication with third party payor representatives to resolve claim issues.
- Identifies, reviews, and interprets third party denials
- Initiates corrected claims and appeals according to payer guidelines.
- Keeps abreast of all government, managed care and third-party hospital coding, billing and reimbursement rules, regulations, and guidelines.
- Promotes Teamwork and maintains a positive atmosphere when communicating, both oral and written.
- Completes all assignments per the turnaround standards. Reports unfinished assignments to the Supervisor.
- Meets productivity standards or consistently exceeds productivity standards
Location: remote,
Type: Contract
Pay: Apply for details
1695