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Heart of The Rockies Regional Medical Center
Salida, Colorado
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Denial Management Specialist
Job DescriptionOverviewUnder general supervision, this position is responsible for the receipt, investigation and creation of the data record for medical necessity audits and denials. Reviews referrals for appropriateness and gathers information necessary for assigning appeal to appropriate clinical team. Contacts vendors, insurance companies, and other departments regarding appeal status and utilization review activity. Coordinates the preparation and posting of appeal packets. Key ResponsibilitiesCreate and update denial tracking records consistently and thoroughly throughout the appeals process. Research denials to obtain a complete and accurate
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