. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding... record reviews for clinical validation of diagnosis and procedure code assignment and MS-DRG/APR-DRG accuracy based...
. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks outcomes... require record review. Provides billing with information needed to obtain payment of claims. JOB DUTIES AND RESPONSIBILITIES...