Clinical Denials and Appeals Expert
6 days ago
We are seeking a highly skilled Clinical Denials and Appeals Expert to join our team at Insight Global.
The estimated salary for this position is $85,000 - $110,000 per year, depending on experience.
About the RoleThis is a hybrid role that requires strong analytical and communication skills. As a Clinical Denials and Appeals Expert, you will work closely with our denial management department to review claims denied for coding-related root causes and suggest process improvements to reduce future denials.
You will be responsible for performing retrospective and prospective account reviews, analyzing coding-related denials, and developing process improvements for coding and documentation workflows. You will also provide regular feedback to denial management team members and coding/physician educators to promote departmental knowledge of best practices within coding.
Key Responsibilities- Perform retrospective and prospective account reviews to ensure accurate coding and documentation.
- Analyze coding-related denials to identify trends and root causes.
- Develop process improvements for coding and documentation workflows based on denial analysis and industry coding guidelines.
- Organize data into clear reports for denial management leadership, physician advisors, and providers.
- Provide regular feedback to denial management team members and coding/physician educators.
To be successful in this role, you will need:
- A minimum of 3 years of coding, denial management, and/or reimbursement experience.
- Current coding certification (RHIA, RHIT, CPC, CCS).
- Strong analytical and communication skills.
- Ability to work independently and as part of a team.
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