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Parallon Workforce Management Solutions - HOUSTON, TX US
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Parallon Workforce Management Solutions - HOUSTON, TX US
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RN/LPN Clinical Appeals Specialist - Houston, Texas US
Unit:
PATIENT ACCOUNT SERVICES
Job Summary:
Monitor insurance denials by running appropriate reports and contacting insurance companies to resolve claims denied for clinical reasons Identify coding or clinical documentation issues and work to correct the errors in a timely manner Identify problem accounts and escalates as appropriate Update the patient account record to identify actions taken on the account Work with guarantors to secure payment on account balances outstanding for clinical reasons Practice and adhere to the Code of Conduct philosophy and Mission and Value Statement Other duties as assigned
Requirements:
RN/LPN Associate's Degree preferred 1 yr of case management in an acute setting preferred. Experience related to monitoring and appealing denials received from Third Party Payors