Clinical Appeals Specialist
PAS - Dallas - Irving, TX

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The Clinical Appeals Specialist handles appeals requiring clinical input or interpretation. Job tasks and responsibilities include:

Monitors insurance denials by running appropriate reports and contacting insurance companies to resolve claims denied for clinical reasons

Identifies coding or clinical documentation issues and works to correct them in a timely manner


Job qualifications include:
Associate or Vocational Degree in Nursing preferred but not required

Must have at least one year of case management experience or relevant education

Strong communication, interpersonal and customer service skills required

Demonstrates proficiency in Microsoft Office applications

Able to work in a fast-paced environment