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Position Summary The Revenue Cycle Specialist will be responsible for the day-to-day operation in the following areas: billing, claims generation and pre-bill review, A/R follow-up including denials and correspondence processing, credit balance, EDI billing/claim edits, and/or
Reviews provider appeals to ensure medical necessity and experimental/investigational claims were processed correctly according to multiple coverage guidelines. Makes final determination based on findings and procedures within strict timelines established by regulatory requirements. Authors within final
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