• RN Denials Management Specialist

    AdventHealth (Altamonte Springs, FL)
    … root cause and bring about the best opportunity for fair reimbursement. The Clinical Denial Management Specialist will adhere to the AHS Compliance Plan and ... . Advanced degree in any field of study . Experience in denial management , utilization review, case management , clinical documentation improvement, revenue… more
    AdventHealth (11/23/24)
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  • RCM Specialist

    Ally Pediatric Therapy (Chandler, AZ)
    …verification, authorization management , charge entry, claims submission, payment posting, and denial management . The specialist will work closely with ... The ABA Full Revenue Cycle Specialist is responsible for managing all aspects of...discrepancies. - Address underpayments, overpayments, and adjustments with payers. Denial Management & Appeals: - Analyze and… more
    Ally Pediatric Therapy (11/13/24)
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  • Inpatient Coding Denial Specialist

    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 ... Do you want to work as an Inpatient Coding Denial Specialist where your passion for creating...or CCS preferred " **Parallon** provides full-service revenue cycle management , or total patient account resolution, for HCA Healthcare.… more
    HCA Healthcare (09/25/24)
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  • Specialist -Quality Assurance Denial

    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
    Baptist Memorial (10/16/24)
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  • Specialist - Denial II RN - HS…

    Baptist Memorial (Memphis, TN)
    …organizational skills. Experience Preferred: Five years clinical experience and 3-5 years case management or denial management experience. Minimum: RN, 5 ... education + Employee referral program Job Summary: Position: 3484 - Specialist - Denial II RN Facility: BMHCC Corporate Office Department: HS Denial more
    Baptist Memorial (10/24/24)
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  • Denial Specialist - Hybrid

    Beth Israel Lahey Health (Danvers, MA)
    …graduate preferred. + 2-3 years' experience in the billing services and denial management . Experience with automated receivable software necessary. + Ability ... that they are maintained at the levels expected by management . + Analyzes work queues and other system reports...Analyzes work queues and other system reports and identifies denial /non-payment trends and reports them to the Billing Supervisor.… more
    Beth Israel Lahey Health (11/10/24)
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  • Denials Specialist 2 / HIM Coding

    Hartford HealthCare (Farmington, CT)
    …now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. ... *Key Areas of Responsibility* *Denials Resolution* . Manages the HIM Coding Denial work queue and collaborates with coding managers and other departments as… more
    Hartford HealthCare (11/06/24)
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  • Utilization Management Specialist

    Mount Sinai Health System (New York, NY)
    **Job Description** **Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay. This… more
    Mount Sinai Health System (11/14/24)
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  • Coding Charges & Denials Specialist

    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
    Houston Methodist (09/18/24)
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  • Revenue Cycle Specialist -Revenue Integrity…

    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...standards are met for billing. + Analyze for invalid denial trends, payer specific carrier submission requirements & system… more
    Weill Cornell Medical College (11/21/24)
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  • Care Specialist - SRS Inpatient Case…

    Sharp HealthCare (San Diego, CA)
    …and maintain case files.Provide clerical support and assistance to the Case Management team.Contributes to the continuous improvement initiatives of the Case ... Management team to deliver quality interventions timely.Maintain data, run...benefit guidelines to approve referrals designated at the Care Specialist level.Investigate and follow-up on all eligibility issues in… more
    Sharp HealthCare (11/13/24)
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  • Billing/Insurance Collections Specialist

    CAIPA MSO LLC (New York, NY)
    …collections specialists with assistance in the follow-up of outstanding claims payments. + Denial Management to include payer denials and denial solutions. ... 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 (10/11/24)
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  • Risk Management Specialist

    City of New York (New York, NY)
    …is provided to those who fail to meet requirements. Your Impact: The Risk Management Specialist will identify and address potential risk for fraud. The ... of HPD's Section 8 program rules. Responsibilities: The Risk Management Specialist will be responsible for the...forward with assistance, entering into repayment agreement or subsidy denial or termination based on the research conducted with… more
    City of New York (11/24/24)
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  • Revenue Cycle Specialist II

    Priority Health Care (Marrero, LA)
    …on claim status, billing and re-billing of claims, credit balance resolution, denial management , following up on aging accounts, maintaining up-to-date account ... JOB SUMMARY: The Revenue Cycle Specialist II must adhere to the Code of...verify balances due on disputed claims, and coordinating payor denial and appeal follow-up activities. This also involves ensuring… more
    Priority Health Care (10/24/24)
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  • Care Management Specialist

    Alameda Health System (Oakland, CA)
    Care Management Specialist + Oakland, CA + Highland General Hospital + HGH Care Coordination + Services As Needed / Per Diem - Day + Care Management + Req ... Denial Letters, patient choice forms; regularly updates Care Management team. 10. Supports any audits with coordinating medical...GED Required Experience: One year experience in a case management specialist position in an acute care… more
    Alameda Health System (11/19/24)
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  • Utilization Management Nurse…

    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
    LA Care Health Plan (11/09/24)
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  • Senior Risk Management Specialist

    UPMC (Pittsburgh, PA)
    UPMC Corporate is hiring a Senior Risk Management Specialist to join our team! This role will be a casual opportunity that works mostly weekends. At the ... and the ability to provide direction. The Senior Risk Management Specialist , must be able to collaborate...and make appropriate recommendations to Director for approval or denial of requests for reimbursement or adjustments of claims.… more
    UPMC (11/02/24)
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  • Coding Appeals Specialist

    TEKsystems (Glen Burnie, MD)
    …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 assist with… more
    TEKsystems (11/21/24)
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  • Coding Appeals Specialist

    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 assist with… more
    TEKsystems (11/21/24)
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  • Case Management Support Specialist

    Health First (Melbourne, FL)
    *POSITION SUMMARY * The Case Management Support Specialist position is responsible for providing Quality/No Harm, Customer Experience, and Stewardship by ... **Job:** **Clerical Support* **Organization:** **Holmes Regional Medical Center* **Title:** *Case Management Support Specialist - Case Management *… more
    Health First (11/26/24)
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