- CHRISTUS Health (Wake Village, TX)
- …studying recent trends in both marketing and health care Maintains an admission/ denial log, making recommendations for alternative placement if unable to service the ... patient in the Continuum of Care Requirements: Education/Skills Associate's Degree in Nursing Experience 1 year of experience preferred Knowledge of Medicare guidelines Licenses, Registrations, or Certifications RN License in state of employment or compact… more
- HCA Healthcare (Fort Lauderdale, FL)
- …Are you ready to manage in a new era as a Division Manager of Denial Prevention where building a healthier tomorrow is more than a job? Our HCA Healthcare ... at an HCA Healthcare facility. Be an impact as a(an) Division Manager of Denial Prevention where your passion for leading and creativity are valued? We want your… more
- HCA Healthcare (Nashville, TN)
- …Bonus Eligible* Do you have the career opportunities as an Inpatient Coding Denial Specialist you want with your current employer? We have an exciting opportunity ... 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? If… more
- Nuvance Health (Danbury, CT)
- …manner in collaborationand working closely with the physical advisors, Clinical Denial Specialist nurses, Case managers, Case Management Operation Coordinators, and ... in work queue and incoming fax queue. 2. Reviews denial letters through daily mail. 3. Identifies retro denials...timeframe. 8. Documents and updates the denials in the denial tracking tool timely and accurately. 9. Collects and… more
- Baptist Memorial (Memphis, TN)
- …services to determine appeal action. Reports to the manager of the Denial Mitigation Department. Performs other duties as assigned. Responsibilities + Reviews, ... Preferred: Five years clinical experience and 3-5 years case management or denial management experience. Minimum: RN, 5 years clinical experience in a clinical… more
- Baptist Memorial (Memphis, TN)
- Summary The Denial Mitigation Specialist - Denial Escalation Quality Assurance evaluates the adequacy and effectiveness of internal and operational controls ... + Employee referral program Job Summary: Position: 19873 - Supervisor-Quality Assurance Denial Escalation Facility: BMHCC Corporate Office Department: HS Denial … more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Denial Resource Center Appeal Support Specialist is responsible for ensuring that complete and accurate appeals of denied claims are submitted to ... the patient's records to verify the reason for the denial and if authorization was required and/or obtained. Completes...obtained. Completes an appeal letter with details of the denial and information to support overturning the claim. Pulls… more
- Hartford HealthCare (Farmington, CT)
- …estimates and collection of patient cost share with a focus on claim denial prevention by collaborating with clinical teams, business partners and insurance payers. ... established requirements in an effort to facilitate payer follow up and support denial dispute 7. True to HHC Mission and Values, demonstrate positive and effective… more
- UCLA Health (Los Angeles, CA)
- …You will review for appropriate care and setting while working closely with denial coordinators and other staff to ensure the accurate processing of all written ... notifications. You will also provide clinical guidance on denial cases and ensure that all denial letters are written and issued according to internal policies… more
- Acacia Network (Bronx, NY)
- Finance Denial Analyst Bronx, NY : 3/11/2024 Job Description Job ID#: 3830 Job Category: Finance Position Type: Full Time Details: Under the supervision of the ... Director of Revenue Cycle, the denial analyst will be responsible for timely billing and...+ Check patient payments. + Reviewing EOBs + Claim denial reconciliation. + Other duties and responsibilities assigned by… more
- Carle (Urbana, IL)
- Outpatient Denial /Appeals Specialist- RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + Employment ... clinical documentation review to establish and manage clinical and prior authorization denial appeals for the Carle enterprise. Represents Carle in clinical meetings… more
- Premier Health (Dayton, OH)
- …The DMCA is responsible for resolving third party payor denials and identifying denial trends by payer. The DMCA is knowledgeable of third party payer contracts, ... and Medicaid guidelines, and other regulations which impact the utilization or denial of provider services. Essential Duties & Functions: 1. Responds positively to,… more
- Sanford Health (Sioux Falls, SD)
- …and interpreting medical policies. The As a lead position, lead appeals and denial specialist this role will additional support the leads the team by providing ... possesses the ability to identify resources and support processes for the appeal and denial team. Serves as the go to source for complex questions and issues.… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission ... staff for single or low volume errors. Report high volume coding denial trends to the coordinator + Maintain meticulous documentation, spreadsheets, account, and… more
- Crouse Hospital (Syracuse, NY)
- The DRG Denial Specialist works under the Inpatient Coding Manager and oversees compliance with coding standards and regulations. Advises and assists in improvement ... plans for coding and DRG assignment issues. Validates assignment of codes and provides trending and analysis of coding and DRG issues. Works using the mission, vision, and values of the hospital. Requirements Education: Associates Degree in Health Information… more
- Amentum (Quantico, VA)
- …+ Conduct All-Source analysis of foreign states and non-state actors' ability to mislead an adversary by manipulation, distortion, or falsification of evidence to ... induce a targeted observer's reactions in a manner prejudicial to the observer's interests. + Conduct All-Source analysis of adversarial attempts to control what US intelligence collection assets and efforts observe and acquire to manipulate perceptions and… more
- Hartford HealthCare (Farmington, CT)
- …*Key Areas of Responsibility* *Denials Resolution* . Manages the HIM Coding Denial work queue and collaborates with coding managers and other departments as ... vendor. Reviews audit findings and schedules quarterly meeting to provide updates on denial trends. . Conducts account research and works with others as needed to… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …process. The Denials RN performs a root cause analysis of the concurrent denial , formulates and implements a plan for addressing the specific root cause for ... that denial , identifies gaps in processes that lead to concurrent...critical thinking skills, and physician advisor review. 2. Identifies denial root cause for each individual concurrent denial… more
- Arnot Health (Elmira, NY)
- …on Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management ( denial /prior auth) will review and appeal as appropriate for concurrent and retrospective ... authorization and denial activities for Arnot Health. Identify, track and trend,...and or payments. Assists in tracking/trending by payer for denial reason items such as prior authorization, untimely filing,… more
- Central Maine Medical Center (Lewiston, ME)
- …in compliance with departmental policies and procedures 3. composing technical denial language for reconsideration, including both written and telephonic 4. ensuring ... payers, hospital departments, and patients to obtain information required for denial resolution following payer timelines. 5. Releases information following Federal,… more
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