Denial Management Research and determine claim denials and take appropriate action for payment within federal, state, and payor guidelines. Trend Identification Identify consistent payor or system trends that result in underpayments, denials, errors, etc. Payor Escalation Ability to understand and navigate payor guidelines. Determine and escalate claim issues with payor w

Include Ensure patient demographic information is accurate and complete Utilize customer hospital systems or approved vendors to research and obtain/verify patient demographic information Validate signature documents such as AOB (Assignment of Benefits), consents, CMN (Certificate of Medical Necessity) Verify patient name is consistent on all documents Verify date of servi