• Spec- Denials and Appeals PBR

    Genesis Healthcare (Seven Fields, PA)
    …your expertise with our Clinicians in Action professional development program. Responsibilities The Denials and Appeals Specialist is responsible for the ... Part-Time team members. + **Support for New Grads & Clinical Fellows:** Our Powerback Clinical Mentorship Program...appeal letters supporting the claim and reimbursement. Performs all appeals and denials recovery procedures needed to… more
    Genesis Healthcare (01/10/25)
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  • Clinical Denials Coding Review…

    HCA Healthcare (Nashville, TN)
    …**Introduction** Do you want to join an organization that invests in you as a Clinical Denials Coding Review Specialist ? At Work from Home, you come ... lives and you have the opportunity to make a difference. We are looking for a dedicated Clinical Denials Coding Review Specialist like you to be a part of… more
    HCA Healthcare (01/18/25)
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  • Coding Charges & Denials Specialist

    Houston Methodist (Houston, TX)
    …staff; and functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** + Communicates openly in a ... At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating... is responsible for coordinating and monitoring the coding-specific clinical charges and denial management and appeals more
    Houston Methodist (01/06/25)
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  • Denials Specialist 2 / HIM Coding

    Hartford HealthCare (Farmington, CT)
    …works collaboratively with appropriate teams to prevent future denial. . Coordinates clinical appeals process and participates in compliance investigations as ... Records / Health Information* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 2 / HIM Coding* **Location:**… more
    Hartford HealthCare (11/06/24)
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  • Denials Specialist 1 / HIM Coding

    Hartford HealthCare (Farmington, CT)
    …recognition programs and other common practices across the system. *_JOB SUMMARY_* The Denials Specialist 1 is responsible for HIM Coding denial resolution and ... **Job:** **Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 1 / HIM Coding* **Location:**… more
    Hartford HealthCare (12/06/24)
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  • Clinical Denials Specialist

    Insight Global (Skokie, IL)
    Job Description Insight Global is looking for a clinical denials specialist to join the team at one of your healthcare clients in Chicago. As a Clinical ... Specialist you will be working with the denials team to review and analyze denials ... perspective. This person will be responsible for preparing appeals and communication with the clinical team… more
    Insight Global (01/03/25)
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  • Denials Management Specialist , Full…

    St. Luke's University Health Network (Allentown, PA)
    …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... and rejections. + Assists in preparing reports regarding denials to include volumes, number of appeals ,...preferred. TRAINING AND EXPERIENCE: Minimum of 2-5 years of clinical nursing experience in an acute care hospital setting… more
    St. Luke's University Health Network (12/28/24)
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  • Care Management Clinical Appeals

    Alameda Health System (San Leandro, CA)
    Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... and executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES...the process; assumes the responsibility for coordinating and appealing clinical denials per department policy; develops any… more
    Alameda Health System (01/23/25)
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  • Denials Management Specialist

    McLaren Health Care (Shelby Township, MI)
    …authorizations and submit to payers for reimbursement. 6. Ability to write non- clinical appeals with demonstrating proficiency with timely and successful ... **Position Summary** : The denials management specialist is responsible for...in work queues to ensure timeliness of follow-up and appeals . 2. Tracks and investigates denial trends/ root cause… more
    McLaren Health Care (01/17/25)
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  • Clinical Appeals Specialist

    St. Luke's Health System (Twin Falls, ID)
    …a great place to work. **What You Can Expect:** Under limited supervision, the Clinical Appeals Specialist 2, is responsible for managing client medical ... sources to provide and maintain a single reporting location that reflects clinical denials and appeals activity. + Recommends improvements and modifications… more
    St. Luke's Health System (01/08/25)
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  • Coding Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... or AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and… more
    St. Luke's University Health Network (11/09/24)
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  • Audit and Appeals Specialist

    UCLA Health (Los Angeles, CA)
    …statuses, tracking cases and maintaining updated records in various systems + Review claim denials for clinical issues, prepare appeals , and manage each ... and quality in claim processing. As an Audit and Appeals Specialist , you will: + Facilitate responses...knowledgeable, detail-oriented professional with: + Bachelor's degree in a clinical or related field, or equivalent training and experience… more
    UCLA Health (11/06/24)
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  • Utilization Rev Appeals Spec

    University of Michigan (Ann Arbor, MI)
    …Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and Appeals Specialist has a strong knowledge of medical appeal and audit ... They are knowledgeable about insurance requirements and medical billing practices. The Appeals Specialist will collaborate with multiple departments to maintain… more
    University of Michigan (01/17/25)
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  • Clinical & Coding Specialist

    Independent Health (Buffalo, NY)
    …coding guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records, consultation with ... first-class perks, benefits and commitment to diversity and inclusion. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing… more
    Independent Health (01/14/25)
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  • PRN UR Clinical Specialist (Remote)

    Community Health Systems (Franklin, TN)
    …admission to the hospital as well as continued stay. The Utilization Review Clinical Specialist supports and coordinates the various aspects of the hospital's ... utilization management program, denials and appeals activities, and readmission reduction...with portals, faxes and phone calls. The Utilization Review Clinical Specialist will monitor adherence to the… more
    Community Health Systems (01/16/25)
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  • Revenue Cycle Specialist II

    Priority Health Care (Marrero, LA)
    …also involves ensuring timely response from third-party payors, processing payor denials , documentation requests, and appeals , and monitoring day-to-day ... activities related to appeal follow-up and denials . Additionally, the Specialist is responsible for...by the manager in a timely manner. + Write appeals using established guidelines to resolve claim denials more
    Priority Health Care (01/23/25)
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  • Specialist -Quality Assurance Denial…

    Baptist Memorial (Memphis, TN)
    …debt from potential write-offs due to lack of collections and overturns on payer denials through the appeals process. The role will collaborate with upper ... Summary The Denial Mitigation Specialist - Denial Escalation Quality Assurance evaluates the...Baptist aging AR + Prepare and submit reconsiderations and appeals to timely filing denials and follow… more
    Baptist Memorial (01/15/25)
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  • Specialist -Accounts Receivable Follow Up

    Baptist Memorial (Jackson, MS)
    Summary The Accounts Receivable Follow Up Specialist performs all collection and follow up activities with third party payers to resolve all outstanding balances and ... receivable, percentage of accounts aged greater than 90 days, cash collections, and denials resolution in support of the team efforts in the achievement of accounts… more
    Baptist Memorial (01/15/25)
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  • Physician Utilization Review Specialist Per…

    Hackensack Meridian Health (Hackensack, NJ)
    …j. Develop strategies across all functional departments to reduce clinical denials by: I. Peer-to Peer (P2P) Concurrent appeals ii. Written Concurrent ... **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the...and resolution of activities that assure the integrity of clinical records for the patient population and Hackensack UMC.… more
    Hackensack Meridian Health (11/18/24)
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  • Billing/Insurance Collections Specialist

    CAIPA MSO LLC (New York, NY)
    …and/or Leadership team MINIMUM QUALIFICATIONS + 2+ years of experience in claims denials , rejections and appeals . + Excellent communication and customer service ... Billing/Insurance Collections Specialist New York, NY (http://maps.google.com/maps?q=202+Canal+Street+New+York+NY+USA+10013) Description We are looking for an… more
    CAIPA MSO LLC (01/10/25)
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