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Clinical Denials Analyst
DescriptionSummary:The Clinical Denials Analyst reports to the System Medical Director for Physician Advisory Services and acts as an intermediary between the clinical care team and the Revenue Cycle Appeals Department. This individual will work with the local Utilization Review (UR) teams to review new clinical denials to help determine their root cause, collect relevant information from the care team to aid in the appeals process, and escalate cases requiring Physician Advisor intervention. The successful candidate will demonstrate the ability to locate, research, comprehend and appropriately apply 3rd party payer rules and regulations to case reviews. This will require staying current with payor policy changes and communicating relevant infor


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