Job Summary

A healthcare company has a current position open for a Remote Denials Prevention Specialist.

Core Responsibilities Include:

• Providing timely referral/appeal determination
• Maintaining compliance in turnaround time requirements
• Maintaining and keeping in total confidence, all files, documents and records

Position Requirements Include:

• 2 years managed care experience in UM/CM/CDI Department preferred
• Knowledge of CMS, State Regulations, URAC and NCQA preferred
• ICD10 and CPT coding a plus
• LVN/LPN