Description

What you will do in this role:

Review denied insurance claims for medical treatment, thoroughly analyzing patient medical records to determine if the denial was justifiedPrepare comprehensive appeals packages including detailed clinical narratives and necessary supporting medical records, for presentation to insurance companies to substantiate and advocate for patient access to necessary care, utilizing their clinical expertise to support the medical necessity of requested servicesInitiate appeal letters and briefs for denialsEnsures all appeals are completed within established timelines and in accordance with regulatory and contractual requirementsOther duties as assigned

Qualifications

Must be licensed as a RN, LPN/LVN, PT, or OTMinimum of 2 years on Inpatient Rehabilitation Hospital experienceMinimum 3 years of clinical experienceExcellent oral and written communication and interpersonal skills