Mayo Career Site US
via Oraclecloud
Clinical Appeals Specialist II-Remote
Compensation
$Not specified
Responsibilities
The Clinical Appeals Specialist II is responsible for reviewing clinically related denials and preparing appeal submissions. They act as a liaison to various stakeholders in defending denied claims and providing feedback on denial prevention opportunities.
Full Description
Primary duties may include, but are not limited to, responsibility for reviewing assigned clinically related denials, payer audits, and payer correspondence as well as preparation of relevant appeal submission or audit responses. Utilizes clinical expertise and critical thinking in the evaluation of medical records against appropriate criteria and contract requirements and utilizes appropriate communication style to appeal or defend medically denied claims. Is a liaison and resource to revenue cycle, case management and practice stakeholders in defending clinically denied claims and providing relevant feedback to key stakeholders on denial prevention opportunities.
This job posting was last updated on 12/5/2025
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