Clinical Denial Mitigation Specialist I

Baptist Memorial Health Care Corporation; Memphis (TN); On-site; USD 55,000 - 75,000; Full time

Job summary

Baptist Memorial Health Care Corporation in Memphis is seeking a Denial Mitigation Reviewer to evaluate clinical information and supporting documentation for outpatient and Part B services to determine appeal actions. You will report to the manager of the Denial Mitigation Department and perform duties as assigned.

The role requires 3 years of clinical experience and payer experience, strong typing and organizational skills, and familiarity with EMR and claims systems in outpatient or inpatient

Qualifications

• 3 years clinical experience and at least 3 years payer experience.
• Ability to type accurately and have strong organizational skills.
• Experience in outpatient or inpatient clinical settings; familiarity with electronic medical records and claims/practice management systems.

Responsibilities

• Reviews, assesses, and evaluates all communications received to optimize reimbursement.
• Evaluates clinical information and supporting documentation prior to initial appeal action to optimize reimbursement and resource utilization.
• Prepares responses to appeals or requests for information based on supporting clinical information to enhance reimbursement and customer satisfaction.
• Compiles, analyzes, and distributes necessary clinical and financial information and presents reports to other healthcare providers to improve performance and resource awareness.
• Completes assigned goals.

Skills

Excellent communication skills

Advanced computer literacy

Typing accuracy

Job description

Baptist Memorial Health Care Corporation in Memphis is seeking a Denial Mitigation Reviewer to evaluate clinical information and supporting documentation for outpatient and Part B services to determine appeal actions. You will report to the manager of the Denial Mitigation Department and perform duties as assigned.

The role requires 3 years of clinical experience and payer experience, strong typing and organizational skills, and familiarity with EMR and claims systems in outpatient or inpatient