• 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 ... Denials Specialist you will be working with the denials team to review and analyze denials from a clinical perspective. This person will be… more
    Insight Global (01/03/25)
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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 ... 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 our team.… more
    HCA Healthcare (01/18/25)
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  • Clinical Denials & Appeals…

    Northwell Health (Melville, NY)
    …utilization management using evidenced-based medical necessity criteria; conducts clinical reviews and formulates appeal letters to support appropriateness ... Ensures compliance with current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect… more
    Northwell Health (01/25/25)
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  • Patient Account Specialist

    Dayton Children's Hospital (Dayton, OH)
    …or GED Experience + Customer service in a call center setting (preferred) + Clinical denials experience (preferred) + EPIC experience is a plus + Insurance ... Facility:Work From Home - OhioDepartment: Clinical DenialsSchedule:Full timeHours:40Job Details:Responsible for all billing and collection activity for assigned… more
    Dayton Children's Hospital (01/22/25)
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  • PRN Utilization Review Clinical

    Community Health Systems (Franklin, TN)
    …required based on hospital and/or corporate policies/procedures. + In the event of concurrent denials , the UR Clinical Specialist reviews the denial and ... in such a way that minimizes the risk of denials after discharge. The hours for this position will...payer requirements. These discussions are to help the UR Clinical Specialist understand the reason for admission,… more
    Community Health Systems (01/19/25)
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  • Coding Charges & Denials Specialist

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial ... payers to successfully clear front end claim edits, appeal clinical denials , and address customer service inquiries....Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved Specialty Society Coding… more
    Houston Methodist (01/06/25)
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  • Denials Specialist 2 / HIM Coding

    Hartford HealthCare (Farmington, CT)
    …Records / Health Information* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 2 / HIM Coding* **Location:** ... process changes. . Works with and provides education to HHC staff on denials issues related to reimbursement, clinical criteria, insurance plan changes,… 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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  • 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 tracks outcomes regarding appeal process. Assists billing staff regarding outpatient denials for experimental, coding or other issues that may require record… more
    St. Luke's University Health Network (12/28/24)
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  • Denials Management Specialist

    McLaren Health Care (Shelby Township, MI)
    **Position Summary** : The denials management specialist is responsible for timely and accurate follow-up and appeal of denials /rejections received from ... and submit to payers for reimbursement. 6. Ability to write non- clinical appeals with demonstrating proficiency with timely and successful submissions. 7.… more
    McLaren Health Care (01/17/25)
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  • Healthcare Claims Denials Specialist

    CenterWell (Jefferson City, MO)
    …our caring community and help us put health first** As an **Accounts Receivable Specialist ** , you will: + Ensure the coordination of claim activities and designated ... patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow… more
    CenterWell (01/17/25)
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  • Spec- Denials and Appeals PBR

    Genesis Healthcare (Seven Fields, PA)
    …expertise with our Clinicians in Action professional development program. Responsibilities The Denials and Appeals Specialist is responsible for the follow up ... plans to Full-Time and Part-Time team members. + **Support for New Grads & Clinical Fellows:** Our Powerback Clinical Mentorship Program kicks off on day one,… more
    Genesis Healthcare (01/10/25)
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  • Coder II ( Denials ) - FT - Days

    Texas Health Resources (Arlington, TX)
    **Coder II - Denials ** _Are you looking for a rewarding career with a top-notch health care company? We're looking for a qualified_ **Coder II** _like you to join ... Professional Coder Upon Hire **REQUIRED** or CCS-P - Certified Coding Specialist - Physician-based Upon Hire **REQUIRED** and Other Specialty certification such… more
    Texas Health Resources (01/18/25)
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  • Accounts Resolution Specialist I - Ophth…

    Penn Medicine (Philadelphia, PA)
    …day. Are you living your life's work? **Job Title:** Accounts Resolution Specialist I **Department:** Ophth Clinical Support **Location:** Penn Presbyterian ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
    Penn Medicine (12/03/24)
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  • Care Management Clinical Appeals…

    Alameda Health System (San Leandro, CA)
    …made to discontinue the process; assumes the responsibility for coordinating and appealing clinical denials per department policy; develops any appeal letters to ... Care Management Clinical Appeals Specialist + San Leandro,...Management team when cases do not meet criteria; coordinates denials with the attending physician and the Care Management… more
    Alameda Health System (01/23/25)
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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 initiatives. The...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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  • Clinical Documentation Integrity…

    WellSpan Health (Ephrata, PA)
    Clinical Documentation Integrity Specialist II - Day Location: WellSpan Health, Ephrata, PA Schedule: Full Time Schedule Full Time: 40 Hours/Week Hours: 8am - ... 4:30pm POSITION REQUIRES that you hold either a Certified Clinical Documentation Specialist or Certified Document Integrity Practitioner Certification This is a… more
    WellSpan Health (12/06/24)
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  • Clinical Appeals Specialist

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

    Independent Health (Buffalo, NY)
    …first-class perks, benefits and commitment to diversity and inclusion. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing ... coding patterns and share knowledge and audit tips across the team. The Clinical & Coding Specialist -Senior will support the leadership in Hospital Audit… more
    Independent Health (01/14/25)
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  • Clinical Documentation Specialist

    University of Texas Rio Grande Valley (Harlingen, TX)
    Position Information Posting NumberSRGV7961 Working TitleCLINICAL DOCUMENTATION SPECIALIST Number of Vacancies1 LocationHarlingen, Texas DepartmentSchool of ... Medicine/ Revenue Cycle FTE1.0 FLSAExempt Scope of Job To promote appropriate clinical documentation through collaboration with the School of Medicine clinical more
    University of Texas Rio Grande Valley (01/04/25)
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