Position Purpose:
Generates, processes and maintains provider and member correspondence for preservice and concurrent review.



Education/Experience:

Requires a High School diploma or GED

Requires – years of related experience.





Knowledge of denials process including understanding medical record information preferred.



Generates correspondence from EMR documentation and ensures correspondence tasks are processed in a timely manner to ensure compliance according to regulatory standards and policies



Updates and maintains correspondence templates based on regulatory, and interdepartmental correspondence inquiries



Coordinates all data collection, analysis, and reporting activities that impact the denial process



Assists with the compliance and turn-around time (TAT) log for all correspondence notifications

Performs other duties as assigned


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