Clinical Denials Specialist (prn)

UASI Solutions

Remote
Remote
Clinical denial reviews
Drg denials experience
Analyze billing statements
UASI Solutions is seeking a Clinical Denials Specialist to conduct clinical denial reviews and audits related to hospital billing and compliance. The ideal candidate should have clinical experience in an acute care setting and knowledge of hospital billing procedures, particularly in handling DRG denials

Job Summary

  • Completes clinical review of pre- and post-claim denials, including DRG Denials.
  • Reviews and analyzes client inpatient and/or outpatient itemized billing statements and patient medical records to identify billing errors.
  • Offers a comprehensive benefit package including medical, dental, vision, life insurance, 401(K), and training opportunities.

Matching Summary

Match Score: 85

UASI Solutions is seeking a Clinical Denials Specialist to conduct clinical denial reviews and audits related to hospital billing and compliance. The ideal candidate should have clinical experience in an acute care setting and knowledge of hospital billing procedures, particularly in handling DRG denials.

Skills & Requirements

Must-have

  • Clinical denial reviews
  • DRG Denials experience
  • Analyze billing statements
  • Analyze patient medical records
  • Communicate effectively

Nice-to-have

  • Analytical thinking process
  • Client-hospital finance interaction

Key Requirements

  • RN Certification
  • CCDS or CDIS Certification preferred
  • Epic experience preferred
  • InterQual and Medical Necessity experience
  • Ability to read and comprehend itemized billing statement, patient medical record and other laboratory reports
  • Ability to analyze medical information and determine appropriate billing procedures

Work Rights

Not specified

Tailored Resume

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