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Denial Resource Center RN
JOB SUMMARYThe Denial Resource Center Registered Nurse (RN) is responsible for Baylor Scott & White Health denial management functions. The Denial Resource Center (DRC) is responsible for receiving claim denials and appealing to payors to promote appropriate reimbursement from payors to BSWH hospitals. The DRC RN manages denials from all payors, including denials for lack of medical necessity, pre-cert, re-cert, billing, coding, and patient status.ESSENTIAL FUNCTIONS OF THE ROLE Review coding and clinical denials to ensure accuracy and compliance with guidelines. Write effective appeals usin
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