Base: $52,395.20-$77,948.00; bonus/equity: not app...
Fully remote
Epic medical record review
Medicare, medicaid, managed, commercial appeals
Identify root causes for denials
The Clinical Denial Specialist II functions as a hospital liaison to appeal denied claims for Medicare, Medicaid, Managed and Commercial insurance
Job Summary
The Clinical Denial Specialist II functions as a hospital liaison to appeal denied claims for Medicare, Medicaid, Managed and Commercial insurance.
This position entails detailed retrospective review via EPIC of patient medical records to analyze and compile data for additional documentation request and claim denials, using trends and patterns identified to support process improvement.
Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.
Matching Summary
The Clinical Denial Specialist II functions as a hospital liaison to appeal denied claims for Medicare, Medicaid, Managed and Commercial insurance.
Salary
Base: $52395.20-$77948.00; Bonus/Equity: Not Applicable; Benefits: Provided
Skills & Requirements
Must-have
EPIC medical record review
Medicare, Medicaid, Managed, Commercial appeals
Identify root causes for denials
Process improvement using trends
Adherence to insurance and CMS guidelines
Nice-to-have
Compassionate, comprehensive care
Catholic health care system
Key Requirements
Active Indiana RN license
BSN or Associate's with 5 years nursing experience