Job Summary Reviews clinical information and supporting documentation for outpatient or Part B services to determine appeal action. Reports to the manager of the Denial Mitigation Department. Performs other duties as ass…
Culinary Specialist - Midtown Center for Health and - Food
Memphis, Tennessee, United States · On-site
Entry level
Job Description The Food Service Worker will assist the manager with food/meal preparation; maintain cash receipts and meal records. Assist manager in completing daily reports. Maintain high standards of quality in food …
Speech Language Pathologist – Memphis, TN FOX Rehabilitation is growing in Memphis, TN, and we’re looking for passionate, licensed Speech Language Pathologists who want to deliver exceptional one-on-one care to older adu…
Skills: Speech Language Pathology, Geriatric care, Patient evaluation, Treatment planning, Evidence-based practice
At Zimmer Biomet, we believe in pushing the boundaries of innovation and driving our mission forward. As a global medical technology leader for nearly 100 years, a patient’s mobility is enhanced by a Zimmer Biomet produc…
Job Summary Obtains accurate demographic, financial and clinical information and enters into the computer system to create the medical and financial record. Applies financial guidelines to determine/collect patient liabi…
Skills: Patient registration, Data entry, Financial screening, Customer service, Communication skills
We are looking for individuals who want to join our team in Memphis, Tennessee. Apply now! Job Opportunity: Psychiatrist Location: Memphis, Tennessee Start Date: Immediate Schedule: Full-Time (Monday–Friday, 8:00 AM–4:30…
Skills: Psychiatric care, Inpatient care, Outpatient care, Diagnosis, Treatment planning
To Qualify For This Position you MUST Currently Reside in Tennessee AdvanceCare Health Services, LLC is looking for a Part-Time Waiver/DDA Program Consultant formerly (DIDD Department of Intellectual & Developmental Disa…
Skills: Compliance, Documentation, Record retention, Programmatic evaluation, Regulatory guidelines
Meridian Life Science, Inc.
Manager, Logistics
Memphis, Tennessee, United States · On-site
Senior
About Meridian Meridian Bioscience is a fully integrated life science company that develops, manufactures, markets and distributes a broad range of innovative diagnostic products. We are dedicated to developing and deliv…
Job Summary Maintains patient and non-patient care areas, within the hospital, and keeps them in a safe and attractive condition. Actively participates in department quality/performance improvement activities and demonst…
Owns healthcare RFP execution strategy and capability development. Drives standardization, pipeline readiness, and continuous improvement to improve win rates, cycle time, and scalability across the healthcare portfolio.…
Skills: Healthcare RFP, Proposal Development, Strategic Planning, Governance, Process Improvement
If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associa…
Job Summary Lead, plan, and coordinate projects from initiation through delivery. Gather required data from stakeholders to evaluate objectives, goals, and scope to create plans to execute the project. Serve as liaison i…
For over 35 years, Youth Villages has transformed the lives of children and families nationwide through innovative, research-based programs focused on preserving and restoring families. As a national leader in children’s…
Overview PURPOSE STATEMENT: Clinical professional is responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care fo…
Caregiver / Direct Support Professional / DSP / Memphis TN
Memphis, Tennessee, United States · On-site
Entry level
We are hiring for: Caregiver / Direct Support Professional / DSP / Memphis TN Type: Regular If you are a positive and personable individual looking for a satisfying and fun opportunity to make a real difference in the li…
Skills: Person-Centered Support, Advocacy, Community Integration, Personal Care, Medication Administration
Owns healthcare RFP execution strategy and capability development. Drives standardization, pipeline readiness, and continuous improvement to improve win rates, cycle time, and scalability across the healthcare portfolio.…
Skills: RFP execution, Pricing governance, Regulatory risk, Business acumen, Proposal development
Job Summary Practices autonomously and in collaboration with other health care professionals to treat and manage patient's health problems and serve in various settings as researchers, consultants, and patient advocates …
Create a working atmosphere, in accordance with Food Services’ mission and guiding principles, where the highest standards of excellence, professionalism, leadership, respect, and culinary pride are displayed daily. Prep…
Skills: Culinary arts, Food preparation, Menu planning, Leadership, Food safety
Description Provide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient's future-as well as your own. Connect with your goals an…
Sign up with Clera and we'll reach out the moment a role actually fits you — no more spraying applications into the void.
Full-time
professional certificate
Posted 11d ago
~40 hrs/week
Responsibilities
The Denial Mitigation Specialist reviews clinical information and supporting documentation to determine appeal actions and optimize reimbursement. They also compile and present clinical and financial reports to healthcare providers to improve performance and resource utilization.
Requirements
Candidates must have at least 3 years of clinical experience and 3 years of payer experience. Proficiency in electronic medical records, claims management systems, and strong critical thinking skills are required.
Full job description
Job Summary
Reviews clinical information and supporting documentation for outpatient or Part B services to determine appeal action. Reports to the manager of the Denial Mitigation Department. Performs other duties as assigned.
Job Responsibilities
• Reviews, assesses, and evaluates all communications received in order to optimize reimbursement. • Evaluates clinical information and supportive documentation prior to initial appeal action in order to optimize reimbursement and utilization of resources. • Prepares response to appeal/request for information based on supporting clinical information in order to enhance reimbursement and maximize customer satisfaction. • Compiles, analyzes, and distributes necessary clinical and financial information and presents reports to other healthcare providers in order to improve performances, and increase awareness of resources consumed related to reimbursement. • Completes assigned goals.
Minimum Required Experience
3 years clinical experience and at least or 3 years payer experience.
Minimum Required Education
Ability to type and/or key accurately and have strong organizational skills.
Minimum Required Training
Requires critical thinking and judgement and must demonstrates the ability to appropriately use standard criteria established by payers. Experienced in working in an outpatient or inpatient clinical setting. Familiarity with electronic medical records and claims/practice management systems.
Minimum Required Special Skills
Excellent communication skills. Advanced computer literacy skills with the ability to type and key accurately.
Preferred/Desired Licensure
RN, LPN or RHIT preferred not required
Related keywords
Denial MitigationClinical DocumentationReimbursementAppealsHealthcarePayer ExperienceElectronic Medical RecordsClaims ManagementUtilization ReviewReportingData AnalysisRNLPNRHITOutpatient ServicesPart B Services
Baptist Memorial Health Care is one of the country’s largest not-for-profit health care systems and the largest provider of Medicaid in the region. Baptist offers a full continuum of care to communities throughout the Mid-South and consistently ranks among the top integrated health care networks in the country. The health care system comprises 24 affiliate hospitals in West Tennessee, Mississippi and East Arkansas; more than 5,400 affiliated physicians; Baptist Medical Group, a multispecialty physician group with more than 900 providers; home, hospice and psychiatric care; minor medical centers and clinics; a network of surgery, rehabilitation and other outpatient centers; and an education system highlighted by Baptist Health Sciences University (formerly Baptist College of Health Sciences). Baptist employs more than 21,000 people, and in fiscal year 2022 contributed more than $455 million in community benefit and uncompensated care to the communities it serves. For more information, please visit www.baptistonline.org or follow us on Facebook or Instagram.
Offices: 350 N Humphreys Blvd, Memphis, Tennessee 38120, US
HospitalHealth CareRehabilitationNon ProfitWellnessMedicalGovernmentNursing and Residential CareHealthcare Services & HospitalsHealthcare
How many Healthcare jobs are open in Memphis, TN right now?
There are currently 1,935 open healthcare positions in Memphis, TN listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Healthcare roles in Memphis, TN?
Companies currently hiring include Baptist Memorial Health Care, Methodist Le Bonheur Healthcare, Regional One Health, St. Jude Children's Research Hospital - ALSAC, Tenet Healthcare, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Healthcare jobs in Memphis, TN?
Yes — 111 of the 1935 open healthcare positions offer remote or hybrid work (51 remote, 60 hybrid).
How do I apply for Healthcare jobs in Memphis, TN?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.