Job Description

The Clinical Denial Coordinator is responsible for the identification, mitigation, and prevention of clinical denials. This position is responsible in preparing clinical disputes based upon evidence base criteria documented within the respective medical record. The Clinical Denial Coordinator will conduct analysis on denials and appeal, identifying and presenting both process improvements and revenue protection opportunities. The position will monitor state and federal regulatory agencies to maintain up-to-date knowledge on changing rules and regulations affecting denial prevention and management practice. Additionally, the Clinical Denial Coordinator will stay abreast of payer clinical policies to dispute denials and provide education for prevention of denials, included but not limited to Quality Improvement Organization, Managed Care Clinical Policies, and both National and Local Coverage Determinations

Application Instructions

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