Senior Appeal and Denial Specialist
10000 Sanford(14 days ago)
About this role
Sanford Health is seeking a clinical professional to facilitate the denial and appeal process by reviewing medical records for medical necessity and policy compliance. The role involves applying clinical expertise, ensuring regulatory adherence, and promoting best practices across the department. It offers a remote or hybrid work environment and the opportunity to contribute to healthcare compliance and case management.
Required Skills
- Clinical Knowledge
- Medical Records
- Regulatory Compliance
- Appeals Process
- Healthcare Policies
- Medical Necessity
- Case Management
- Communication
- AudiT & Audit
- Healthcare Regulations
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