Utilization Review Appeals Spec RN
Company: OAK10-McLaren Oakland-Hospital
Location: Pontiac
Posted on: January 9, 2021
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Job Description:
Utilization Review App Spec RN - (20010565)Position Summary:
Coordinates/handles the appeals process for third party payer
denials, primarily RAC-related activities and commercial appeals
beyond the first level, requiring complex clinical review.
Responsible for collecting, analyzing, and reporting clinical risk
factors for level of care discrepancies. Supports the overall
quality, completeness of clinical documentation, and intensity of
service application during the appeal process to ensure proper
reimbursement is achieved.Essential Functions and
Responsibilities:
Keywords: OAK10-McLaren Oakland-Hospital, Pontiac , Utilization Review Appeals Spec RN, Healthcare , Pontiac, Michigan
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