- Fairview Health Services (St. Paul, MN)
- **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by the ... pertaining to billing, coding, and documentation. The Inpatient Coding Denials Specialist will also handle audit-related and compliance responsibilities.… more
- UNC Health Care (Kinston, NC)
- …all denial requests and leads the team in the strategy to appeal all clinical denials . Provides the clinical expertise to draft the first and second levels of an ... of services. Responsibilities: 1. Provides clinical expertise and organization to manage denials . 2. Stays up to date and proactive with all ongoing information,… more
- University of Southern California (Alhambra, CA)
- …& state coding compliance regulations and guidelines, the HIM Coding Denials Management Specialist" analyze, investigate, mitigate, and resolve all coding-related ... 'claims denials ' and 'claims rejections,' specific to ICD-10-CM, ICD-10-PCS, CPT/HCPCS,...covered patients. Manages the denial management process for coding-related denials , triage denied claims to distinguish coding-related denials… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... to make appropriate decisions and is accountable for reviewing denials for level of care, medical necessity, and as...care, medical necessity, and as appropriate, DRG recoupments/downgrades, and denials for no authorization. The Senior Denials … more
- Hartford HealthCare (Farmington, CT)
- …The Denial Specialist 2 is responsible for reviewing, analyzing, and appealing denials related to DRG (Diagnostic Related Group) validation denials . This ... *Key Areas of Responsibility* *Denial Resolution* . Review DRG validation denials from payers, analyze the denial reasons, and determine the appropriateness… more
- Rush University Medical Center (Chicago, IL)
- …depending on the circumstances of each case. **Summary:** The system manager of denials prevention and appeals, working in a remote environment will lead several ... accuracy and appropriate reimbursement. This leader will identify root causes of denials , propose preventative measures with the use of Epic automation and ancillary… more
- Addiction Recovery Care (Lexington, KY)
- …and stewardship are key elements of everything we do! We are hiring a Denials Resolution Specialist to our growing team! Under direct supervision the Denials ... + Conducts root cause analysis of all assigned insurance payer claims and denials to determine appropriate actions required to resolve the claim / denial into… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Medical Billing & Denials Specialist Department: Patient Financial Services Location: SLH - Regional Administrative Campus Hours Per Week: 40 Schedule: ... 8am-4pm SUMMARY: A Medical Billing and Denials Specialist is responsible for managing the billing process, submitting claims to insurance companies, following up on… more
- Community Health Systems (Franklin, TN)
- …and address denial trends. This role plays a critical part in the denials management process, supporting efforts to improve claims resolution, reduce future ... denials , and ensure compliance with payer guidelines. As a...BARRT, and other host systems, ensuring timely follow-up on denials and appeals. + Conducts follow-up calls and payer… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …We are currently seeking a *PFS Contract Variance Analyst** *to join our Denials Analysis team. This full-time role will work remotely (Days, M- F). *Purpose ... managing appeals related to payer contract variances and fatal denials . This role is responsible for assisting with appeal...data to help identify trends in contract variances and denials * Prepares standard reports and summaries for review… more
- Rochester Regional Health (Rochester, NY)
- JOB TITLE: Collections and Denials Management Representative LOCATION: SLH DEPARTMENT: Patient Financial Services Hours: 37.5 SCHEDULE: Monday-Friday 8AM-4PM ... SUMMARY: A Medical Billing and Denials Specialist is responsible for managing the billing process,...management of the healthcare organization by identifying trends in denials and taking corrective actions. RESPONSIBILITIES: + Medical Billing… more
- Saratoga Hospital (Saratoga Springs, NY)
- HIS Denials Specialist (Inpatient) Location: Saratoga Hospital, 211 Church Street, Saratoga Springs, NY 12866 Employment Type: Full Time Shift/Schedule: 8a-4p ... About the Role We're looking for a dedicated HIS Denials Specialist to join our team and help us...Patient Access (PA) and Patient Financial Services (PFS). The Denials Specialist is responsible for tracking denied HIS inpatient… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …We are currently seeking a *PFS Contract Variance Analyst Senior** *to join our Denials Analysis team. This full-time role will work remotly (Days, M- F). *Purpose ... for leading the end-to-end appeals process related to contract variances and fatal denials . This role serves as a subject matter expert, managing complex appeal… more
- Robert Half Accountemps (Minnetonka, MN)
- Description We are looking for a detail-oriented Denials Specialist to join our team in Minnetonka, Minnesota on a contract basis. In this role, you will be ... with regulations, and contributing to process improvements that minimize future denials . This position requires strong analytical skills and a thorough understanding… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …more **Epic Certification required.** **Description** **RESPONSIBILITIES:** + The System Denials Analyst, is responsible for gathering, analyzing, and reporting data ... related to both hospital and professional billing denials across the healthcare system. + Reporting to the...to assist leadership in making data-driven decisions to reduce denials and improve overall Data Collection and Reporting +… more
- CommonSpirit Health (Englewood, CO)
- …needs of patients and alternative levels of care. **The PA performs denials management and prevention in accordance with the organization's goals and expectations. ... concerns raised by the payer, and provides additional context to overturn denials before escalation to formal appeal.** + Reviews and analyzes denied claims… more
- Aspirus Ironwood Hospital (Wausau, WI)
- …Every. Single. Day. Aspirus Health in Wausau, WI is seeking a Billing & Denials Specialist to join our team! The Billing and Denial Specialist I is responsible ... following up claims with no response from payers, working and managing insurance denials , managing, writing, and carrying out the appeal process for all payers. Is… more
- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ... and trending all appeals and communicating on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care contracting team with… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for accuracy in ... appeal status. + Consults with Coordinator and/or Director, Coding Denials and Appeals during any audit discrepancies. + Attends...of work products by the Coordinator and/or Director, Coding Denials and Appeals. + Partners with peers and Director… more
- Penn Medicine (East Petersburg, PA)
- …shape our future each day. Are you living your life's work? Job: Denials Management Specialist Hours: Day shift hours, start time between 07:00am-9:00am (8 hour ... are met in an appropriate manner. Responsibilities: + Analyzes and researches denials and follows-up with the appropriate payor, practice, and/or patient to resolve… more
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