Full time, Full Time
UVA Health System
Haymarket, VA, USA
UOVUNIUSR0067121EXTERNALENUS
Obtains complex pre-certification for all inpatient admission and pre-authorization for all outpatient diagnostic tests and performs an administrative support function. This job requires the application and interpretation of policies and procedures and the use of independent judgment in a medical setting. The purpose is to achieve the goals and to meet the denial rates set by Patient Access, the Medical Center and HSF to ensure minimum loss of revenue and maximum payment for services. Utilizing persuasive clinical arguments and tenacious communication skills, both oral and written, creates and submits appeal letters as needed to overturn denials. Utilizes critical thinking and root cause problem solving methodology to discern trends in payor behaviors and/or our clinical documentation/practice that need to be communicated back to departments or physicians in order to prevent continuing denials. Will also work with leadership and communicate routinely...