- 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 ... 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 you… more
- Sanford Health (Sioux Falls, SD)
- …documentation, and interpreting medical policies. The As a lead position, lead appeals and denial specialist this role will additional support the leads the team ... 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
- Banner Health (AZ)
- …looking to leverage your abilities - apply today. The Registered Nurse RN Denial Management Specialist is responsible for reviewing concurrent inpatient denials ... **Primary City/State:** Arizona, Arizona **Department Name:** Denial Recovery-Corp **Work Shift:** Day **Job Category:** Revenue Cycle Nursing careers are better at… more
- Baptist Memorial (Memphis, TN)
- Summary Authorization Denial Specialist ensures that chemotherapy (specialty group) and other infusions/radiation therapy/radiology/ surgical services meet ... education + Employee referral program Job Summary: Position: 18063 - Specialist -Authorization Denial Facility: BMHCC Corporate Office Department: HS … more
- Baptist Memorial (Memphis, TN)
- …assistance/continuing education + Employee referral program Job Summary: Position: 3484 - Specialist - Denial II RN Facility: BMHCC Corporate Office Department: HS ... services to determine appeal action. Reports to the manager of the Denial Mitigation Department. Performs other duties as assigned. Responsibilities + Reviews,… more
- 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
- 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 ... to guidelines set forth by the payer. The Appeal Support Specialist processes submissions of reconsiderations, redeterminations, appeals, resubmissions of previously… more
- Beth Israel Lahey Health (Danvers, MA)
- …by management. + Analyzes work queues and other system reports and identifies denial /non-payment trends and reports them to the Billing Supervisor. + Ability to ... billing system in order to identify paid claims or root cause of denial when assessing denials. + Responds to incoming insurance/office calls with professionalism… more
- Nuvance Health (Danbury, CT)
- …manner in collaborationand working closely with the physical advisors, Clinical Denial Specialist nurses, Case managers, Case Management Operation Coordinators, ... 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
- TEKsystems (Austin, TX)
- We are hiring for Hospital Denial Management specialists to support a growing healthcare RCM company! As a specialist on our team you will be verifying insurance ... increase cash flow Day to Day Duties: - Each specialist will be assigned an inventory to work. New...and left a balance or denied it and the specialist needs to assist. - Could be coded incorrectly… more
- Guthrie (Sayre, PA)
- …payer guidelines resulting in appeal or charge correction. Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects, request ... payers. Reports possible payer or submission issues. 2. Works closely with a Denial Resolution Specialist or Billing Specialist II mentor to cross train on… more
- Ally Pediatric Therapy (Chandler, AZ)
- …verification, authorization management, charge entry, claims submission, payment posting, and denial management. The specialist will work closely with clinical ... 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 resolve claim… more
- CaroMont Health (Gastonia, NC)
- …Maintains the Status Change Database. Performs retrospective clinical reviews/appeals as part of denial process. The UR Specialist will be cross trained to work ... attending physicians regarding utilization issues. Collaborates with discharge planning specialist and other disciplines. Retrospectively reviews discharged medical record… 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 ... collaboration with the Claim Editing Manager, Physician, Specialty Coder, AR specialist or Auditor/Educator. Demonstrate the ability to formulate an appeal rationale… 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
- McLaren Health Care (Bay City, MI)
- …Responsible for timely and accurate processing, follow-up, and appeal of audits and denial activity received from payers and/or auditors . Provides support to both ... internal and external customers for denial /appeals activities and audits. Assists with monitoring and auditing activities, reviews outcomes and communicates findings… 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 ... exposure caused by front end claim edits and retrospective denial of payments for services provided. This position will...Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved Specialty Society Coding… more
- Weill Cornell Medical College (New York, NY)
- Title: Revenue Cycle Specialist -Revenue Integrity (Remote) Location: Midtown Org Unit: AR - Coding Medicine Work Days: Weekly Hours: 35.00 Exemption Status: ... standards are met for billing. + Analyze for invalid denial trends, payer specific carrier submission requirements & system...as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) is required.** + Should be certified from… more
- TEKsystems (Jackson, MS)
- Revenue Cycle/Appeals Specialist Needed Description: 100% Remote Equipment Provided The Appeals Specialist 1, under the direction of the Director of Denial ... prepay insurance denials, correlating with the follow-up teams. -Works closely with Denial Coordinator, Facility Denial Liaison, and Managed Care Coordinator for… more
- 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 information ... and entered into electronic tracking system including the following: Process payer denial correspondence mail, end of day reports and fax, enter payer requests,… more
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