Responsible for reviewing medical records and preparing clinical appeals in response to medical necessity denials and DRG reassignments. Responsibilities Prepare professional, effective clinical appeals in response to managed care, governmental, or RAC denials for hospital clients. Utilize
Responsible for reviewing medical records and preparing clinical appeals in response to medical necessity denials and diagnosis-related groups (DRG) reassignments Responsibilities Prepare and submit clinical appeals in response to denials from managed care organizations, governmental entities, and
Responsible for daily coding, auditing and diagnosis-related group (DRG) validation of assigned encounters is accurate and compliant with outpatient standards Responsibilities Conduct reviews and provide recommended corrections of billed services for medical records, ensuring accuracy and compliance