UM & Clinical Denials Assistant, PRN

Responsibilities:

• Provide support to the Utilization Management Nurse and RN Appeals Writer.
• Help to prevent clinical denials related to lack of clinical, lack of authorization and untimely notifications.
• Work closely with the physician to ensure that peer-to-peer reviews are completed in a timely manner.

Qualifications:

• H.S. Diploma or General Education Degree (GED) Required
• Associate’s Degree in human services/healthcare related field, or coding Preferred
• 3 years of experience in either hospital billing, Care Management, utilization review or commercial / managed care.