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Job Summary:
Supports the Revenue Management Department by auditing medical records and clinical documentation to ensure proper patient status placement, accurate coding, and defensible payer billing. Focuses on clinical denials, observation services, documentation gaps, and payer requirements for authorization and coverage. Collaborates with Case Management, Utilization Management, Coding, Medical Officer, and Physician Advisors to reduce clinical denials, improve documentation quality, and ensure compliance with regulatory and payer standards. Provides analytic reports and feedback to identify systemic trends and educational opportunities.
Job Requirements:
Education and Work Experience: