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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 Recovery
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 with
