Job Details

A company is looking for a Clinical Denial Specialist.Key ResponsibilitiesReceive, triage, and prioritize denied hospital claims based on various factorsConduct root cause analysis to identify reasons for denial and coordinate with relevant teamsAssemble and submit appeal packets, ensuring compliance with clinical documentation and payer requirementsRequired QualificationsAssociate or bachelor's degree in healthcare administration, medical assistant, health information management, or a related fieldPrior experience in hospital revenue cycle, clinical denials, appeals, or medical claims processingStrong understanding of payer denial codes and hospital billing processes