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How do you prioritize denials in an AR work queue?

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Short Answer

I prioritize denials by filing deadline, dollar value, likelihood of recovery, payer response time, denial age, recurring root cause, and any issue that could affect multiple claims.

Detailed Answer

A productive denial queue should not be worked only from oldest to newest or highest balance to lowest.

I would consider:

  • Appeal or reconsideration deadline
  • Claim balance
  • Days in AR
  • Probability of overturn
  • Payer turnaround time
  • Volume of similar denials
  • Whether resolving one root cause can release many claims

Deadline risk usually comes first because a high-value claim can become unrecoverable if the appeal window expires.

Key Points to Mention

  • Protect filing deadlines first.
  • Consider balance and recoverability.
  • Prioritize systemic issues affecting many claims.
  • Use denial age and payer turnaround strategically.

Example Scenario

A $500 claim has three days left to appeal, while a $5,000 claim has 45 days remaining. The smaller claim may require immediate action first because its recovery window is about to close.

Common Mistakes

  • Working only by dollar value.
  • Ignoring appeal deadlines.
  • Failing to identify high-volume root causes.

Interview Tip

Explain your prioritization logic with a deadline example.

#AR Work Queue#Appeals#Denial Prioritization

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