Appeals and Denials Author

Job Summary

A company is looking for an Appeals and Denials Author.

Key Responsibilities:

• Conduct detailed review of patient medical records and payer denial information
• Assess hospital stay and clinical course to determine if payer denial was justified
• Prepare written appeals or represent clients at telephonic hearings

Required Qualifications:

• RN license with strong appeals experience or Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) medical license
• At least 2 years of clinical experience with inpatient care
• Knowledge of, or experience in working with the verbal and written appeals process
• Experience with electronic medical record systems and proficiency with MS Word
• Understanding of DRG/coding principles and familiarity with both inpatient and outpatient care and procedures in multiple specialties