Reviews clinical information and supporting documentation for outpatient or Part B services to determine appeal action. Reports to the manager of the Denial Mitigation Department. Performs other duties as assigned.
3 years clinical experience and at least or 3 years payer experience.
Ability to type and/or key accurately and have strong organizational skills.
Requires critical thinking and judgement and must demonstrates the ability to appropriately use standard criteria established by payers.
Experienced in working in an outpatient or inpatient clinical setting.
Familiarity with electronic medical records and claims/practice management systems.
Excellent communication skills.
Advanced computer literacy skills with the ability to type and key accurately.
RN, LPN or RHIT preferred not required
Baptist Memorial Health Care is one of the country’s largest not-for-profit health care systems and the largest provider of Medicaid in the region. Baptist offers a full continuum of care to communities throughout the Mid-South and consistently ranks among the top integrated health care networks in the country. The health care system comprises 24 affiliate hospitals in West Tennessee, Mississippi and East Arkansas; more than 5,400 affiliated physicians; Baptist Medical Group, a multispecialty physician group with more than 900 providers; home, hospice and psychiatric care; minor medical centers and clinics; a network of surgery, rehabilitation and other outpatient centers; and an education system highlighted by Baptist Health Sciences University (formerly Baptist College of Health Sciences). Baptist employs more than 21,000 people, and in fiscal year 2022 contributed more than $455 million in community benefit and uncompensated care to the communities it serves. For more information, please visit www.baptistonline.org or follow us on Facebook or Instagram.
