Clinical Denials Analyst II

1 week ago

Worcester, Western Cape, South Africa Hahhh Full time
Main Responsibilities

The Denial Resolution Specialist will resolve accounts with high dollar balances (>$100,000) recognizing the potential complexity and need for rapid resolution.

This role also involves analyzing and researching denial reasons for each assigned denial code.

The specialist will participate in payer and internal audits, maintaining appropriate documentation related to original audit findings.

This includes correcting and updating claim information in the Medicare FISS system and completing actions needed for an effective appeal.