- HCA Healthcare (Nashville, TN)
- …Sign-On Bonus Eligible* Do you have the career opportunities as an Inpatient Coding Denial Specialist you want with your current employer? We have an exciting ... caring group of colleagues. Do you want to work as an Inpatient Coding Denial Specialist where your passion for creating positive patient interactions is valued?… more
- Baptist Memorial (Memphis, TN)
- Summary The Denial Mitigation Specialist - Denial Escalation Quality Assurance evaluates the adequacy and effectiveness of internal and operational controls ... including federal and state regulations and guidelines. The Quality Assurance Specialist will be responsible for analyzing and interpreting trends associated with… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records ... not limited to utilization review, hospital reimbursement, clinical compliance, case management , and transitions of care, as outlined in the responsibilities below.… more
- Houston Methodist (Houston, TX)
- …is responsible for coordinating and monitoring the coding-specific clinical charges and denial management and appeals process in a collaborative environment with ... feasibility of submitting appeals. + Works with revenue cycle management and staff to ensure claim edit/ denial ...Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved Specialty Society Coding… more
- Weill Cornell Medical College (New York, NY)
- …critical thinking and analytical skills. + Ability to meet daily coding and denial management production requirements along with quality as per Company norms. ... Title: Revenue Cycle Specialist -Revenue Integrity (REMOTE) Location: Midtown Org Unit: AR...retrospective coding and documentation review of denied charges for physician services. Reviews medical records for completeness and accuracy… more
- Sharp HealthCare (San Diego, CA)
- …and PCP, health plans and other service providers.Make phone calls to members, physician offices, health plans, and providers to assist in care coordination under ... and maintain case files.Provide clerical support and assistance to the Case Management team.Contributes to the continuous improvement initiatives of the Case … more
- Alameda Health System (San Leandro, CA)
- … team when cases do not meet criteria; coordinates denials with the attending physician and the Care Management physician advisor; prepares case reports; ... Care Management Clinical Appeals Specialist + San...guidelines; refers questionable cases to the CM Manager or physician advisor for determination. 3. Collaborates and communicates regularly… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically… more
- TEKsystems (Glen Burnie, MD)
- …coding guidelines. 7. Organizes data into clear reports that are presented to denial management leadership, physician advisors, and providers. 9. Provides ... regular feedback to denial management team members and coding/ physician educators to promote departmental knowledge of best practices within coding. 11. May… more
- TEKsystems (Odenton, MD)
- …coding guidelines. + Organizes data into clear reports that are presented to denial management leadership, physician advisors, and providers. + Provides ... regular feedback to denial management team members and coding/ physician educators to promote departmental knowledge of best practices within coding. + May… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is ... identified by the Revenue Cycle Managers. In addition, the Revenue Cycle Specialist is responsible for resolving all outstanding third-party primary and secondary… more
- Hackensack Meridian Health (North Bergen, NJ)
- … Management , including insurance authorization, payer communications, Appeals and Denial information, and scheduling. **Responsibilities** A day in the life of ... a **Care Coordination Specialist ** at **Hackensack Meridian** **_Health_** includes: **Utilization Management...provides information as requested. + Prepares required Appeals and Denial information for processing and follows up on receipt… more
- UPMC (Pittsburgh, PA)
- …To perform authorization activities of inpatient, outpatient and emergency department patients, denial management and all revenue functions. Need to demonstrate, ... **UPMC University of Pittsburgh Physicians is hiring a full-time Authorization Specialist to join their team at the** Heart Vascular Institute at CHP! This position… more
- St. Luke's University Health Network (Allentown, PA)
- …strategies for clinical documentation or current program in use for clinical documentation management program. 11. Work with the physician advisor in review of ... of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis… more
- CaroMont Health (Gastonia, NC)
- …Maintains the Status Change Database. Performs retrospective clinical reviews/appeals as part of denial process. The UR Specialist will be cross trained to work ... to ensure status and medical necessity are accurately determined. Refers to physician advisor and /or second level reviewer when necessary. Documents initial review,… more
- Catholic Health Initiatives (Little Rock, AR)
- **Overview** As our Denials Management Specialist at CHI St. Vincent Heart Clinic of Arkansas, you will help our revenue cycle team recover maximum reimbursement ... to perform thorough claim analysis, communicate effectively with payers, and implement denial prevention strategies. To be successful in this role, you must have… more
- Hackensack Meridian Health (Tinton Falls, NJ)
- …payment and/or denial postings across the Hackensack Meridian Health (HMH) physician network. This process verifies that the payment received for the account is ... Cash/ERA Reconcil Analyst, PB supports daily/weekly cash reconciliation functions for the physician network and reconciles bank deposits to assure timely posting of… more
- Henry Ford Health System (Troy, MI)
- …successful authorization procurement is obtained from back end coding, billing and denial management resources and distributed to ordering physicians and ... The purpose of the Central Authorization Specialist position is to centrally facilitate the successful procuring of insurance authorizations for ordered procedures… more
- Federal Aviation Administration (Oklahoma City, OK)
- Summary This position is a Physician and serves as a Medical Officer Trainer and Quality Assurance Reviewer within the FAA, Aviation Safety (AVS), Office of ... and manages medical programs in support of Aviation Safety. Responsibilities The Physician is a recognized medical authority who provides highly complex and… more
- Sutter Health (Berkeley, CA)
- …hospital admission, need for continued stay, and proper utilization of physician , nursing, and ancillary services. Responsible for concurrent review on specific ... patients. Develops, coordinates and monitors systems for the appeal/ denial process, tracks and trends data, and coordinates utilization management activities for… more