ID | 2024-141285 | Line of Business | BrightSpring Health Services | Position Type | Full-Time |
BrightSpring Health Services
Clinical Denials Management and Audit monitors, responds to, and performs the clinical denial and appeal processes across Home Health branches for all payor types striving to improve clinical documentation and minimize lost revenue. They conduct analysis on denials and appeals and identify trends that present process improvement and revenue protection opportunities. Monitor state and federal regulatory agencies to maintain up-to-date knowledge of changing rules and regulations relating to payer requirements and documentation. This position supports the development of standard operating procedures and plans, training, and provides subject matter expertise around clinical documentation and denials management. They will also support detailed level reporting and analytics, clinical appeals, root cause analysis, and address identified trends in reasons for denials; work in partnership with Home Health operations and customers to drive improvement in the quality of services delivered to patients.