Summary The denials specialist is responsible for appealing and resolving claim denials. Responsibilities include: determining the root cause of the denial, appealing the denial, pursuing the payor for reconsideration, taking appropriate resolution steps, tracking recoveries, and successfully recovering denied amounts as efficiently as possible. Working under the direction of the Reimbursement Manager, the Denials Specialist assists in tracking and reporting payor denials and contract-related discrepancies. Denials are referred to the Denials Specialist via a denials work queue based upon the reason code provided by the payor on the
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