Clinical Denials Appeals Specialist

A company is looking for a Clinical Denials Prevention & Appeals Specialist.

Key Responsibilities

Review and appeal clinical validation denials, identifying grounds for appeal

Compile evidence and create appeal letters to challenge incorrect denials

Analyze denial trends and provide training to minimize future denials

Required Qualifications

Bachelor's degree in health information technology or equivalent, with relevant certification (RHIT, RHIA, RN, NP, PA, or MD)

3-5 years of experience in Clinical Documentation Integrity (CDI) with coded data

Experience in analyzing clinical validation denials and appeal letters

CCDS or CDIP credential, or the ability to obtain within 1 year of hire

Proficiency in productivity, communication, and leadership attributes