- TEKsystems (Austin, TX)
- Description: Job Summary: The Revenue Cycle Denials and Appeals Specialist will be responsible for building and maintaining collaborative and productive ... for the designated revenue cycle function, with a focus on Denials and Appeals * Performs analysis, identifies trends, presents opportunity areas, and… more
- TEKsystems (Charlotte, NC)
- Description: The Revenue Cycle Denials and Appeals Specialist will be responsible for building and maintaining collaborative and productive relationships within ... for the designated revenue cycle function, with a focus on Denials and Appeals * Performs analysis, identifies trends, presents opportunity areas, and… more
- TEKsystems (Addison, TX)
- …a similar role within a healthcare setting. - Familiarity with insurance denials , appeals , and arbitration processes, including knowledge of payer-specific ... reimbursement issues to identify the root causes. - Initiate and manage the appeals and arbitration process for denied or underpaid claims, ensuring timely and… more
- R1 RCM (Boise, ID)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals and Denials Manager** , you will serve as an ... expert on clinical appeals and denials management. Every day you will support client hospitals where claims were denied or underpaid by governmental contractors,… more
- Houston Methodist (Houston, TX)
- …Revenue Cycle experience** At Houston Methodist, the Accounts Receivable (AR) Appeals Denials Specialist position is responsible for reviewing accounts ... the payor's medical policy or the contract. Drafts and submits appeals using a sound argument for denials that have a reasonable chance of being overturned. +… more
- TEKsystems (Boise, ID)
- …If you have experience working within medical insurance roles handling claims, payer portals, appeals , AR follow up, denials or anything within revenue cycle we ... position is highly focused on the resolution of insurance processing errors and denials . Payers include but are not limited to Medicare, Medicaid, Blue Cross, and… more
- Amaze Health (Denver, CO)
- …Amaze Health is a company dedicated to empowering our patients with all the tools, resources, and medical support they need to take charge of their own healthcare. We ... don't just take care of people, we partner with them. Join our innovative team as we change healthcare in America, one patient at a time. We are looking for an independent, personable, fast learner to help us provide the best possible experience for every one… more
- Houston Methodist (Houston, TX)
- …coding staff; and functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** + Communicates openly in a ... At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial… more
- McLaren Health Care (Bay City, MI)
- …responsibilities of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and ... . Provides support to both internal and external customers for denial/ appeals activities and audits. Assists with monitoring and auditing activities, reviews… more
- BronxCare Health System (Bronx, NY)
- Overview Assists in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute ... action in order to improve outcomes. - Maintains an excel log related to denials / appeals activities in order to monitor successful appeals . - Assists with… more
- TEKsystems (Addison, TX)
- …to strengthen appeal arguments. Additional Skills & Qualifications: - Proven experience as an Appeals and or denials Specialist or in a similar role within a ... processes, claim adjudication, and reimbursement methodologies. - Familiarity with insurance denials , appeals , and arbitration processes, including knowledge of… more
- WellSpan Health (York, PA)
- …Responsibilities + Oversees the utilization management process for preauthorization, concurrent review, denials and appeals for System acute care facilities. + ... Committee. + Works closely with Medical Director to identify trends in payor denials and appeals . + Serves as point of contact for System acute care utilization… more
- University of Utah (Salt Lake City, UT)
- …+ Demonstrated knowledge of revenue cycle. + Working knowledge of insurance denials , appeals and expected reimbursement rates. + Experience presenting findings ... PRN40045B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt **Patient… more
- CommonSpirit Health (Sacramento, CA)
- …denied claims to determine validity and identify opportunities for overturning inappropriate denials . Leads the appeals process by providing clinical expertise, ... This position will be a part of the specialized Denials Management team. This individual meets with case management...to Peer Reviews + Experience submitting written and verbal appeals + Unrestricted license in field of practice in… more
- Guidehouse (Birmingham, AL)
- …Medical Record + Making outbound calls to Insurance Companies to resolve claim denials and account balances. + Performing Non-Clinical Appeals . + Assisting ... or equivalent. + 0-2 years medical provider experience working with UB04, appeals & denials . **What Would Be Nice to Have** **:** + Basic computer skills.… more
- R1 RCM (Detroit, MI)
- …will help support clinicians who conduct a comprehensive review of clinical denials and formulate appeals based on clinical documentation, evidence-based medical ... patient care as well as conceptual knowledge of the denials landscape. Proficiency in basic computer skills is essential...**Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor the workflow of… more
- Catholic Health Services (Melville, NY)
- … and Authorization representative will perform activities to resolve authorization denials for ambulatory practices, and facilitate appeals for hospital ... documents. Send out collaborative emails to the practices detailing total denials and status on appeals . Prepare appeals for claims the practices provide… more
- Nuvance Health (Danbury, CT)
- …leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff while partnering with ... will be responsible for leading a team encompassing utilization review and denials / appeals specialists and will need to foster a culture of collaboration,… more
- R1 RCM (Salt Lake City, UT)
- …, you will help our hospital clients by serving as an expert on appeals and denials management where claims were denied by either governmental contractors ... patient care as well as conceptual knowledge of the denials landscape. Proficiency in basic computer skills is essential...**Here's what you will experience working as a Clinical Appeals Nurse:** + Conduct a detailed review of patient… more
- Stanford Health Care (Palo Alto, CA)
- …criteria and guidelines to optimize patient outcomes and manage healthcare costs. 4. Denials and Appeals Management: Address and manage denials by ... Working in collaboration with Physician Advisors, Financial Services, Compliance, Denials Management, Patient Access, Clinical Documentation Integrity, Billing, and… more
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