UM & Clinical Denials Asst-PRN
Listed on 2026-10-09
-
Healthcare
Healthcare Administration, Healthcare Management
The purpose of this role is to provide support to the Utilization Management Nurse and RN Appeals Writer in the Care Management Department. This role will help to prevent clinical denials related to lack of clinical, lack of authorization and untimely notifications. This role will work closely with the physician to ensure that peer-to-peer reviews are completed in a timely manner.
This role will be responsible for investigating root cause of clinical denials and documenting them in Epic and follow-up of appeal outcome.
The purpose of this role is to provide support to the Utilization Management Nurse and RN Appeals Writer in the Care Management Department. This role will help to prevent clinical denials related to lack of clinical, lack of authorization and untimely notifications. This role will work closely with the physician to ensure that peer-to-peer reviews are completed in a timely manner.
This role will be responsible for investigating root cause of clinical denials and documenting them in Epic and follow-up of appeal outcome.
- H.S. Diploma or General Education Degree (GED) Required
- Associate’s Degree in human services/healthcare related field, or coding Preferred
- 3 years of experience in either hospital billing, Care Management, utilization review or commercial / managed care. Required
- None Required
Company Name
Piedmont Healthcare Corporate
(If this job is in fact in your jurisdiction, then you may be using a Proxy or VPN to access this site, and to progress further, you should change your connectivity to another mobile device or PC).