Denial Analyst - RN

"Responsible for handling administrative and medical appeals that require clinical input or interpretation, directing and coordinating all aspects of denied claims, provide coordination of comprehensive clinical documentation to third-party payers and state agencies to secure accurate payment, and the ability to identify coding or clinical documentation issues. "

Education - Graduate of accredited school of nursing

Licensure - Current Louisiana State license as RN

• Analysis and Recommendations

• Provides on-going trend analysis to identify reasons for denials and apply corrective actions steps to prevent cash flow retardation.

• Proactively researches and understands payer issues. Troubleshoots and resolves issues that impact revenue. Responsible for facilitating the internal appeal process.

• Actively works through denied claims and attempts to gather information and take appropriate action to ensure claim is adjudicated properly.

• Quality

• Promotes the quality and efficiency of his/her own performance through participation in staff educational programs, approved continuing education courses, and specialized skill training programs.

• Utilizes all equipment, supplies, facilities, and resources in a prudent and efficient manner in order to ensure efficient departmental operations and the provision of high-quality health care services.

• Other Duties as Assigned

• Performs other duties as assigned or requested.

• Analysis and Recommendations

• Provides on-going trend analysis to identify reasons for denials and apply corrective actions steps to prevent cash flow retardation.

• Proactively researches and understands payer issues. Troubleshoots and resolves issues that impact revenue. Responsible for facilitating the internal appeal process.

• Actively works through denied claims and attempts to gather information and take appropriate action to ensure claim is adjudicated properly.

• Quality

• Promotes the quality and efficiency of his/her own performance through participation in staff educational programs, approved continuing education courses, and specialized skill training programs.

• Utilizes all equipment, supplies, facilities, and resources in a prudent and efficient manner in order to ensure efficient departmental operations and the provision of high-quality health care services.

• Other Duties as Assigned

• Performs other duties as assigned or requested.