Coordinates review of authorization and denial information between Payers, PAS, PFS, CM’s, Nursing and any other party to optimize reimbursement and decrease denial exposure on inpatients, observation patients and outpatients at Le Bonheur. Reviews denial reports, Out Of Network (OON) reports, Underpayment reports and other data to assist with timely and accurate billing processes. Assists with OON negotiations for Director review and approval as well as securing service authorizations for inpatient and observation stays when referring physicians are OON. Supports Case Manager’s by providing required admission notification to payers, initiating precertifications, populating Utilization Review software with days approved and denied, reviewing accounts to insure all days are approved and provides assistance with coordinating times for physician peer to peer reviews with our payers. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.