"Responsible for handling administrative and medical appeals that require clinical input or interpretation, directing and coordinating all aspects of denied claims, provide coordination of comprehensive clinical documentation to third-party payers and state agencies to secure accurate payment, and the ability to identify coding or clinical documentation issues. " • Analysis and Recommendations • Provides on-going trend analysis to identify reasons for denials and apply corrective actions steps to prevent cash flow retardation. • Proactively researches and understands payer issues. Troubleshoots and resolves issues that impact revenue. Responsible for facilitating the internal appeal process. • Actively works through denied claims and attempts to gather information and take appropriate action to ensure claim is adjudicated properly. • Quality • Promotes the quality and efficiency of his/her own performance through participation in staff educational programs, approved continuing education courses, and specialized skill training programs. • Utilizes all equipment, supplies, facilities, and resources in a prudent and efficient manner in order to ensure efficient departmental operations and the provision of high-quality health care services. • Other Duties as Assigned • Performs other duties as assigned or requested. Education - Graduate of accredited school of nursing Licensure - Current Louisiana State license as RN