Denial Specialist

Job Summary

A company is looking for a Denial Specialist III to manage provider and member correspondence related to preservice and concurrent reviews.

Key Responsibilities

• Generate and process correspondence from EMR documentation to ensure compliance with regulatory standards
• Coordinate data collection, analysis, and reporting activities that impact the denial process
• Assist in identifying root causes of denial issues and train team members on the correspondence process

Required Qualifications

• High School diploma or GED required
• 2 - 4 years of related experience preferred
• Strong knowledge of the denials process and medical record information preferred
• Prior experience generating correspondence in healthcare strongly preferred