Executive resource for claims denied by third-party and governmental payers. This position will collaborate with Revenue Cycle Leadership, Case Management and clinical service areas to proactively develop strategies to prevent, reduce the denial rate and manage denials, i.e. related to medical necessity, timely filing, missing/invalid authorizations, DRG disputes, RAC audits, Inpatient Only procedures, non-covered services, coding and/or documentation.
This position will maintain reporting and collaborate with the Payor Relations and Contracting Department during contract negotiations and settlements on denial issues impacting payment from third party payers for consideration.
Peak Health Solutions, an AMN Healthcare company, is an EEO/AA/Disability/Protected Veteran Employer. We encourage minority and female applicants to apply
This document represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. Other duties may be assigned.
MINIMUM EDUCATION & EXPERIENCE
KNOWLEDGE, SKILLS, & ABILITIES