Analyst

• Conduct thorough analyses of denials, evaluating the appropriateness of medical services and procedures.
• Maintain accurate records of appeals and denials for tracking and reporting purposes.
• Independently compose professional and comprehensive appeal letters to payors after a detailed review of medical records.
• Create comprehensive appeal strategies based on relevant guidelines and documentation to effectively address denials.
• Draft and submit detailed appeal letters along with supporting documentation, ensuring adherence to regulatory requirements and payor guidelines.
• Provide a thoughtful appealability score for each denial under review, assessing the likelihood of a successful appeal.

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