Clinical Denial Management Assistant

Job Summary

Supporting the Clinical Denial Management and Utilization Review teams, the full-time Clinical Denial Management Assistant will manage EPIC work queues, communicate with payers, and assist in the clinical denial appeal process while working remotely during day shifts from Monday through Friday.

Key responsibilities

• Communicates with Clinical Denial Management and Utilization Review teams to ensure timely addressing of denial letters
• Submits appeal documents to payers accurately and promptly while maintaining organized records of clinical appeals
• Reviews denied cases and interacts with insurance providers to gather necessary information for appeals

Required qualifications

• Experience in clinical denial management or utilization review processes
• Familiarity with EPIC software and electronic medical records (EMR)
• Ability to manage and organize multiple tasks and documents systematically
• Proficiency in data reporting and tracking for clinical appeals
• Strong communication skills for effective interaction with payers and clinical teams