Payor Resource Coordinator

Job Objective Works to secure reimbursement for care provided by working closely with Payer, ensuring authorization, notification, and clinical reviews are completed and faxed in a timely manner by the Case Management staff. Works closely with Clinical Appeal Nurse and department leadership to ensure all denial are appealed and provides follow up with payer on appeal status. Communicates clinical denial and status of appeal to appropriate departments and/or personnel for follow up and documents in EPIC accurately and consistently.