Senior Appeal and Denial Specialist - Remote SD
10000 Sanford(8 days ago)
About this role
Sanford Health is hiring for a role focused on reviewing medical records for medical necessity and policy compliance, managing appeals, and promoting clinical best practices. The position involves coordinating with various healthcare departments, ensuring regulatory compliance, and supporting efforts to resolve denials within a healthcare insurance setting.
Required Skills
- Clinical Knowledge
- Medical Necessity
- Appeals Process
- Regulatory Compliance
- Healthcare Regulations
- Medical Records
- Insurance Policies
- Patient Advocacy
- Audit and Compliance
- Case Management
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