Denial Specialist

Job Summary

A company is looking for a Denial Specialist II who will generate, process, and maintain provider and member correspondence for preservice and concurrent review.

Key Responsibilities

• Generate and process correspondence from EMR documentation to ensure compliance with regulatory standards
• Update and maintain correspondence templates based on regulatory and interdepartmental inquiries
• Coordinate data collection, analysis, and reporting activities related to the denial process

Required Qualifications

• High School diploma or GED is required
• 1 - 2 years of related experience is required
• Knowledge of the denials process and understanding of medical record information is preferred