Clinical Denials Audit & Analysis Specialist, Hybrid, Appeals & Denials, Baptist Metro Square
Job Description
About Baptist Health
Recognized as a top place to work in health care, Baptist Health cares for more patients in Northeast Florida than any other provider, ranking as “most preferred” for more than 30 years. We’re Jacksonville's only locally governed, faith-based, not-for-profit health system and provide a full spectrum of preventive and specialty care through 200+ locations and six hospitals. Our centers of excellence include Baptist MD Anderson Cancer Center, Baptist Heart Hospital, Baptist Neurological Institute and Wolfson Children's Hospital.
Baptist Health is looking to add a Clinical Denials Audit & Analysis Specialist to join our Appeals and Denials Team at Baptist Metro Square. This is a Full-Time Days opportunity.
As a Clinical Denials Audit & Analysis Specialist, you will be responsible for:
- Provides system support for Clinical Denials Audit and Analysis team.
- Works closely with the Denials and Appeals Nurses, Physician Advisors, and CDAA leadership to ensure denials are coordinated and escalations addresses, to ensure maximum reimbursement for the organization.
- Responsible for entry of and follow up on our concurrent (in-house) denials via the Epic Environment.
- Provides coordination for Medicare Discharge Appeals and coordinates with Utilization Management regarding outcomes.
- Schedules and provides clerical support to our Physician Advisors for Peer to Peer and payer escalation requests.
- Provides clerical support to the Denials and Appeals Nurses as required.
- Coordination of multiples requests and denials received via voicemail, fax, and department Outlook mailbox.
Experience Requirements:
1-2 Years Denial/Audit Resolution Required
1-2 Years EMR Experience Required
1-2 Years Clerical Experience Required
1-2 Years Healthcare Experience Preferred
Education & Credential Requirements:
High School Diploma Required
This Clinical Denials Audit & Analysis Specialist will be located at Baptist Metro Square. If you are interested in this Full-Time Days opportunity, please apply now!
Primary Location:
Metro Square