Position Overview
Job Description
Generates, processes and maintains provider and member correspondence for preservice and concurrent review.
Education/Experience:
Requires a High School diploma or GED
Requires – years of related experience.
Knowledge of denials process including understanding medical record information preferred.
Generates correspondence from EMR documentation and ensures correspondence tasks are processed in a timely manner to ensure compliance according to regulatory standards and policies
Updates and maintains correspondence templates based on regulatory, and interdepartmental correspondence inquiries
Coordinates all data collection, analysis, and reporting activities that impact the denial process
Assists with the compliance and turn-around time (TAT) log for all correspondence notifications
Performs other duties as assigned
Complies with all policies and standards
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