Clinical Denial Specialist

Work Schedule :
This is a part time, 0.70 FTE. Scheduled shifts are during daytime hours, Monday - Friday. Hours may vary based on the operational needs of the department. This position is remote. Be part of something remarkable
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We are seeking a Clinical Denial Specialist to:

Research payer denials related to referral, pre-authorization, medical necessity, case management, non-covered services, and billing resulting in denials and delays in payment. Submit detailed, customized appeals to payers based on review of medical records and in accordance with Medicare, Medicaid, and third-party guidelines as well as UW Health policies and procedures. Education :
Minimum - Associate degree in a business or healthcare related field. Two (2) years of relevant experience may be considered in lieu of a degree in addition to the required experience below.
Preferred - Bachelor's Degree or graduate of LPN or RN program Work Experience :
Minimum - Two (2) years recent experience in professional business writing, hospital case management and/or hospital prior authorization
Preferred -

Epic experience in either Resolute Hospital or Professional Billing Three (3) years of experience in a healthcare revenue cycle or clinic operations role with one (1) of those years being in a role which included claim-related appeal writing. Experience with medical and insurance terminology, CPT, ICD coding structures, and billing forms (UB, 1500) Licenses and Certifications :
Preferred - Current LPN or RN licensure Our Commitment to Diversity, Equity, and Inclusion
UW Health is committed to being a diverse, equitable, inclusive and anti-racist workplace and is an Equal Employment Opportunity, Affirmative Action employer. Our integrity shines through in patient care interactions and our daily work practices as we work to embrace the knowledge, unique perspectives and qualities each employee and faculty member brings to work each day. Applications from Black, Indigenous and People of Color (BIPOC) individuals, LGBTQ+ and non-binary identities, women, persons with disabilities, military service members and veterans are strongly encouraged. EOE, including disability/veterans.
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UW Hospital and Clinics benefits