The Denial Management Specialist is responsible for the identification, mitigation and prevention of denials. The Denial Specialist works to prevent future denials by communication with Rev Cycle Leadership about denial root cause. RESPONSIBILITIES : * Analyze and research denials, follow-up with the payer/hospital departments/patient to resolve denials and follow up on denials. * Prepare, review and comply with payer appeal rights. * Responsible for timely responses to specialty payer audits, tracking findings and initiating and/or assisting with denial appeals when appropriate. * Manage denials relating to Coding, NCD, LCD, diagnosis and experimental criteria. * Contribute to the development of all workflows and internal proce
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