- 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
- 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
- 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
- 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
- AdventHealth (Altamonte Springs, FL)
- …you'll contribute:** This position is responsible for investigating and appealing post-remit denials for all Inpatient and Outpatient clinical services across ... bring about the best opportunity for fair reimbursement. The Clinical Denial Management Specialist will adhere to...you bring to the team:** . Reviewing and appealing denials for all clinical services across the… more
- CenterWell (Topeka, KS)
- …of our caring community and help us put health first** As an **Accounts Receivable Specialist /Healthcare Claims Denials Specialist ** , you will: + Ensure the ... patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow… more
- 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
- 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
- Catholic Health Services (Melville, NY)
- …contractual agreements. Staying current on payer policy changes that impact charge capture, denials , and cash. Working with PRC teams and DTS on rules to increase ... revenue and decrease denials and touches based on payer requirement/regulations. DUTIES/RESPONSIBILITIES: Keeps...departments and DTS to build payer rules to reduce denials and increase cash based on payer regulations. Perform… more
- Dartmouth Health (Lebanon, NH)
- …* Utilizes nursing and clinical knowledge to respond to payors concerning clinical denials , as assigned * Provides clinical documentation expertise to ... Overview Clinical Documentation Specialist (Registered Nurse) - Full Time Remote 40 hours per week * Clinical Documentation Specialist experience… more
- Spaulding Rehabilitation (East Sandwich, MA)
- Clinical Documentation Specialist , 20 hours - ( 3307405 ) **Description** Under the direction of the Clinical Documentation Integrity (CDI) Manager, ... Care Team to be successful in this role. Utilizes clinical and ICD 10 coding knowledge to obtain appropriate...compliance, coding staff, physicians, and finance to reduce payment denials and improve medical necessity documentation. + Acts as… more
- Spaulding Rehabilitation (Charlestown, MA)
- Clinical Documentation Integrity Specialist , Per Diem - ( 3303241 ) **Description** **Job Summary** Under the direction of the Clinical Documentation ... Care Team to be successful in this role. Utilizes clinical and ICD 10 coding knowledge to obtain appropriate...compliance, coding staff, physicians, and finance to reduce payment denials and improve medical necessity documentation. * Acts as… more
- HCA Healthcare (Nashville, TN)
- …your knowledge and expertise! **Job Summary and Qualifications** The Inpatient Coding Denials Specialist is a high-level coding expert responsible for ... from payers, preventing lost reimbursement and promoting denial prevention. The Inpatient Coding Denials Specialist will adhere to all rules and regulations of… more
- Health First (Rockledge, FL)
- …Management* **Organization:** **HF Administrative Plan Inc* **Title:** *Prior Authorization Nurse Specialist HFHP - Clinical Operations* **Location:** *Florida - ... responsibilities and rules of engagement between prior authorization processing and clinical decision making. * Partners with appropriate professionals to ensure… more
- Priority Health Care (Marrero, LA)
- …and appeals, and monitoring day-to-day activities related to appeal follow-up and denials . Additionally, the Specialist is responsible for understanding and ... JOB SUMMARY: The Revenue Cycle Specialist II must adhere to the Code of...preparation and delivery of items required for annual audits. Denials Management and Accounts Receivable Follow-Up: + Manage and… 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
- UTMB Health (Galveston, TX)
- Billing Specialist , Ob/Gyn Clinical Support Services (Partial Remote) **Galveston, Texas, United States** Clerical & Administrative Support UTMB Health ... and Contracts + Sterilization Procedure review and remittance to sponsor(s) + TMHP Denials Research + Reporting + Work Queue review and management + CPT Appeals… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Clinical Documentation Integrity Specialist Full-Time, 80 Hours per pay period, Day Shift Covenant Health Overview: Covenant Health is the region's ... the appropriate assignment of a final DRG. The CDI specialist functions as an onsite resource for clinical...Monitors activities and findings with regard to audits and denials and subsequently adjusts to potential trends when reported.… more
- Columbus Regional Hospital (Columbus, IN)
- …Medical Auditor (CPMA), Certified Documentation Improvement Practitioner (CDIP), or Certified Clinical Documentation Integrity Specialist (CCDS) certification ... to know about the position: + The Professional Billing Coding Reimbursement Specialist provides the coding staff with the necessary support for coding guidelines… more
- Baptist Memorial (Memphis, TN)
- Summary The Denial Mitigation Specialist - Denial Escalation Quality Assurance evaluates the adequacy and effectiveness of internal and operational controls designed ... including federal and state regulations and guidelines. The Quality Assurance Specialist will be responsible for analyzing and interpreting trends associated with… more