Clinical Denials Audit & Analysis Specialist, Hybrid, Appeals & Denials, Baptist Metro Square

Job Summary

Baptist Health is looking to add a Clinical Denials Audit & Analysis Specialist to join our Appeals and Denials Team at Baptist Metro Square. This is a Full-Time Days opportunity.

As a Clinical Denials Audit & Analysis Specialist, you will be responsible for:

• Provides system support for Clinical Denials Audit and Analysis team.
• Works closely with the Denials and Appeals Nurses, Physician Advisors, and CDAA leadership to ensure denials are coordinated and escalations addresses, to ensure maximum reimbursement for the organization.
• Responsible for entry of and follow up on our concurrent (in-house) denials via the Epic Environment.
• Provides coordination for Medicare Discharge Appeals and coordinates with Utilization Management regarding outcomes.
• Schedules and provides clerical support to our Physician Advisors for Peer to Peer and payer escalation requests.
• Provides clerical support to the Denials and Appeals Nurses as required.
• Coordination of multiples requests and denials received via voicemail, fax, and department Outlook mailbox.

Experience Requirements:

• 1-2 Years Denial/Audit Resolution Required

• 1-2 Years EMR Experience Required

• 1-2 Years Clerical Experience Required

• 1-2 Years Healthcare Experience Preferred

Education & Credential Requirements:

• High School Diploma Required

This Clinical Denials Audit & Analysis Specialist will be located at Baptist Metro Square. If you are interested in this Full-Time Days opportunity, please apply now!

Education Required

High School

Experience

• Clerical Experience
• EMR experience
• Denial/Audit Resolution

License and Certification

• Driver's License - DMV

Location