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Back to search resultsClinical Denials Management And Audit
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![]() United States, Texas, Dallas | |||||||
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Clinical Denials Management And Audit Job Locations
US-KY-LOUISVILLE | US-TX-DALLAS | US-GA-ATLANTA | US-TN-NASHVILLE
Our Company BrightSpring Health Services Overview 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. Responsibilities
Responsible for responding to, managing, and monitoring payer Additional Documentation Requests (ADR) and communications - works with branch staff to gather required information and submit timely responses to ADR requests
Qualifications
About our Line of Business BrightSpring Health Services provides complementary home- and community-based pharmacy and provider health solutions for complex populations in need of specialized and/or chronic care. Through the Company's service lines, including pharmacy, home health care and primary care, and rehabilitation and behavioral health, we provide comprehensive and more integrated care and clinical solutions in all 50 states to over 450,000 customers, clients and patients daily. BrightSpring has consistently demonstrated strong and often industry-leading quality metrics across its services lines while improving the quality of life and health for high-need individuals and reducing overall costs to the healthcare system. For more information, please visit www.brightspringhealth.com. Follow us on Facebook, LinkedIn, and X. |