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Posted: Wednesday, July 12, 2017 8:21 AM

GENERAL SUMMARY OF DUTIES - The Clinical Appeals Manager manages all activities related to
monitoring and appealing denials received from Third Party Payors.
SUPERVISOR – Clinical Appeals Director
SUPERVISES - Clinical Appeals Specialists
• Manage daily activities related to PAS Clinical Appeals function, ensuring processes are performed
efficiently and effectively
Analyze trends in insurance denials and work with insurance companies to resolve underlying reasons
for denials
Manage recurring coding or clinical documentation issues and correct the underlying causes for errors.
Perform Q/A for Clinical Appeals function
Screen, interview, and hire new employees
Arrange for training of new employees
Review each staff member’s productivity on a monthly basis and performing annual evaluations
Counsel staff with disciplinary and productivity issues
Work as a liaison between the Clinical Appeals staff and other Patient Account Services staff
Resolve issues escalated by Clinical Appeals staff
Conduct monthly staff meetings
Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
Other duties as assigned

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• Location: San Antonio

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