Overview 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. Responsibilities + Reviews, assesses, and evaluates all communications received in order to optimize reimbursement. + Evaluates clinical information and supportive documentation prior to initial appeal action in order to optimize reimbursement and utilization of resources. + Prepares response to appeal/request for information based on supporting clinical information in order to enhance reimbursement and maximize customer satisfaction. + Compiles, analyzes, and distributes necessary clinical and financial information and presents reports to other healthcare providers in order to improve performances, and increase awareness of resources consumed related to reimbursement. + Completes assigned goals. REQNUMBER: 33962