- Glens Falls Hospital (Glens Falls, NY)
- …status protected under law. **Job:** **Allied Health - Health Information Management* **Title:** * Coding Reimbursement Appeals Supervisor - Health ... Director, is responsible for compliant, complete and optimal facility coding , and in collaboration with Coding leadership...and DRG's that include all MCC's and CC's for reimbursement . In collaboration with Hospital External Review Team (HERT)… more
- UNC Health Care (Chapel Hill, NC)
- …managed that have opted into shared services. This position reports to the HCS Supervisor Coding and CDI Quality and Training. This position provides mentoring ... by updating the coding and send for rebilling if required. 5. Generate coding appeals for insurance denials with sound arguments and based on coding… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …Performs coding and documentation quality audits; provides feedback to coding and reimbursement specialists, coders, and educates them. This job ... Texas Medicaid policies. Demonstrate knowledge of compliance documentation and coding standards, seeking guidance from supervisor as...School graduate or equivalency and five (5) years of coding and reimbursement experience of which one… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Coding Specialist position is responsible for applying correct coding conventions to patient charge encounters in a clinical ... reviews and corrects charge review and claim edit related coding errors in the electronic health record. In addition,...other team members as advised by the manager and/or supervisor . **SERVICE ESSENTIAL FUNCTIONS** + Responds to or clarifies… more
- HCA Healthcare (Nashville, TN)
- …is a high-level coding expert responsible for investigating and resolving coding related denials from payers, preventing lost reimbursement and promoting ... payer websites + Escalates problem accounts/processes/trends and report opportunities to supervisor for denial prevention and coding education opportunities +… more
- Aston Carter (Portsmouth, NH)
- Billing Supervisor Portsmouth, NH Responsibilities: + Oversee daily operations of the billing department to ensure timely submission of claims and payments. + Assist ... with surgical coding , ensuring all procedures are accurately coded and compliant...accurately coded and compliant with regulatory standards for optimal reimbursement . + Monitor accounts receivable, following up on unpaid… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Authorization Technician Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... the safety net required to achieve that purpose. Job Summary The Supervisor , Authorization Technician supports the Utilization Management (UM) Specialist by handling… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Claims Job Category: Claims Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11739 Salary ... support the safety net required to achieve that purpose. Job Summary The Claims Supervisor works with the Claims Manager to oversee the daily operations of the… more
- Houston Methodist (Houston, TX)
- …appropriate billing functions, including claims resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for any ... medical necessity or coding related appeals . **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Stays current on collection procedures of various payors and industry… more
- Tufts Medicine (Lowell, MA)
- …verification, claim edits, payer follow-up, correspondence review, corrected claims, appeals , reimbursement verification, and remittance research for assigned ... Lead or Supervisor when appropriate. 11. Reviews, evaluates and processes appeals through research and resubmission to appropriate third party with complete and… more
- Johns Hopkins University (Middle River, MD)
- …(medical reports, authorizations, etc) as needed and submits to third-party payers. + Appeals rejected claims and claims with low reimbursement . + Confirm credit ... for the collection of unpaid third-party claims and resolution of non-standard appeals , using various JHM applications and JHU/ PBS billing applications. Will… more
- Zelis (NJ)
- …policy documents: interpret and document the configurations to be applied to Zelis coding and clinical reviews + Translate client reimbursement policies into ... detailed review of hospital itemized bills for identification of billing and coding opportunities for all payor's claims including restricted list + Review client… more
- State of Colorado (Lakewood, CO)
- …and organizational development services. + Additional benefits offered include tuition reimbursement and reduced college tuition at CSU Global and DeVry University. ... and summarize accounting data for the CDPS Controller's office, Accounting Supervisor , grant administrators, and division managers as required or upon request.… more
- Johns Hopkins University (Middle River, MD)
- …(medical reports, authorizations, etc.) as needed and submits to third-party payers. + Appeals rejected claims and claims with low reimbursement . + Performs ... escalates non-standard appeals to a higher-level specialist. + Informs the supervisor / Production Unit Manager of issues or problems associated with non-payment… more
- Catholic Health Initiatives (Omaha, NE)
- …payers to address and resolve outstanding insurance balances related to coding denials in accordance with established standards, guidelines and requirements. The ... advices, researching denial reasons and resolving issues through well-written appeals . Work requires proactive troubleshooting, significant attention to detail and… more
- MD Anderson Cancer Center (Houston, TX)
- …and further delay in payments. Makes recommendations for resolution. 5. Pursues appeals when available. Initiates communication with coding team and clinical ... staff when coding related and medical necessity appeals are warranted. 6. Consistently reviews processes and recommends any areas of opportunities with assigned… more
- e CancerCare (Nashville, TN)
- …Work an average of 40 to 80 denials per day based on supervisor requirements and accounts assigned. Works closely with insurance carriers for reimbursement ... timely payment Reviews outstanding AR accounts and contacts insurance for reimbursement explanation. Provides clear and accurate documentation of all contacts with… more
- University of Rochester (Rochester, NY)
- …activities of peers and lower-level staff as directed by the Operations Supervisor and Assistant Director, PFS. **Typical Duties** : Under general direction and ... coordinate hospital and departmental procedures relative to charges, billing, reimbursement , and accounting functions associated with Dialysis billing. + Maintain… more
- Elderwood (Waverly, NY)
- …with Medicare experience? Do you consider yourself an expert in assessment and reimbursement methodology? We want to talk with you! RN - MDS Coordinator Position ... Medicare required assessments setting the completion date to maximize reimbursement and RUGs categories for each individual assessment. +...for pre and post-pay record reviews, ADR requests and appeals processes. + Manages NYS RUGs III case mix… more
- BrightSpring Health Services (Valdosta, GA)
- …claim appeals with insurance companies to ensure maximum entitled reimbursement preferred* Responsible use of confidential information.* Must be able to read. ... assigned operations and follow up on all outstanding accounts. Provide proper coding and comments for all outstanding balances.* Provide any additional research for… more