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Continuum Rehab Group

Continuum Rehab Group is dedicated to providing excellent rehabilitative services through compassionate care and exemplary outcomes. The organization emphasizes a shared vision among employees, fostering a culture of integrity, teamwork, and appreciation. They focus on developing their staff while ensuring dignity and compassion in their services.

<div>Requirement: Must be a LVN or RN with prior MDS experience. Prior experience with appeals, denials, and audits preferred. 
This is a Hybrid position based out of our Carrollton office. 
Job Summary
Clinical Appeals &amp; Revenue Specialist
Responsible for managing denied claims and payer audits, preparing and submitting appeal letters and medical records, reviewing clinical documentation for medical necessity, validating coding accuracy, identifying trends in denials, collaborating with MDS team and facility teams to improve outcomes, and ensuring compliance with Medicare, Medicaid, and commercial payer requirements. This position serves as the primary resource for revenue recovery through effective denial prevention, appeal management, and documentation integrity initiatives. 
Key duties:<ul><li>
Review and analyze denied claims</li><li>
Draft and submit appeal and reconsideration letters</li><li>
Validate ICD-10, CPT, HCPCS, and coding as applicable</li><li>
Support ADRs, UPICs, TPE, RAC, and payer audits</li><li>
Track appeal outcomes and denial trends</li><li>
Educate clinical staff on documentation deficiencies</li><li>
Recover lost revenue through successful overturn of denials</li><li>
Maintain compliance with payer and regulatory requirements</li></ul>
To submit your application for this role, please apply here or email your resume to melissa.collier@crgrehab.com
Continuum Rehab Group provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.</div>

Appeal and Denial Specialist Carrollton TX

Join Continuum Rehab Group and explore 1   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Continuum Rehab Group

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Appeal and Denial Specialist Carrollton TX