Clinical Appeals Analyst

• Monitor insurance denials by running appropriate reports and contacting insurance companies to resolve claims denied for clinical reasons

• Identify coding or clinical documentation issues and work to correct the errors in a timely manner

• Identify problem accounts and escalates as appropriate

• Update the patient account record to identify actions taken on the account

• Work with guarantors to secure payment on account balances outstanding for clinical reasons

Associate’s Degree preferred

At least one year case management experience required

Relevant education may substitute experience requirement

Previous Appeals experience highly preferred!