- Northwell Health (Melville, NY)
- …as needed. + Prior experience in Case Management, Utilization Review, and Appeals / Denials , highly preferred. *Additional Salary Detail The salary range and/or ... current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness… more
- R1 RCM (Salt Lake City, UT)
- …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
- University of Michigan (Ann Arbor, MI)
- Revenue Cycle Coding Supervisor - Appeals & Denials Apply Now **Job Summary** The Denial Coding Supervisor provides subject matter expertise in physician medical ... Opening ID** 258393 **Working Title** Revenue Cycle Coding Supervisor - Appeals & Denials **Job Title** Revenue Cycle Coding Supr **Work Location** Michigan… 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
- 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
- R1 RCM (Chicago, IL)
- …you will do initial reviews, call insurance companies to resolve authorization and claim denials , write appeals and letters to insurance companies to resolve ... analytics, AI, intelligent automation, and workflow orchestration. As our Denials and AR Senior Analyst, you will help R1...denials , and follow up on appeals to the point of exhaustion or payment. To… more
- BrightSpring Health Services (Louisville, KY)
- …for all payor types striving to minimize lost revenue. Conducts analysis on denials and appeals and identifies trends that present process improvement and ... Our Company BrightSpring Health Services Overview Director of Clinical Denials Management and Audit supervises a team of RN/LPN...all areas of clinical claim pre and post audit, appeals submission, and reporting to Palmetto in response to… more
- Community Health Systems (Fort Smith, AR)
- As a Remote Medical Denials / Appeals Specialist at Community Health Systems - Shared Services Center, you'll play a vital role in supporting our purpose to help ... flexible scheduling, 401k and student loan repayment programs. The Remote Medical Denials / Appeals Specialist position is remote and full time, which is 40… more
- Molina Healthcare (Columbus, OH)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers... appeals and denials . + Strong verbal and written communication skills To… more
- Community Health Systems (Franklin, TN)
- …to appropriate persons. + Maintain documentation regarding all payor resources regarding denials and appeals processes. + Understand and apply CHS 10-Step ... assigned. + File medical necessity and level of care appeals using InterQual and CMS guidelines as needed. +...related departments as needed. + Track and manage clinical denials using current tools (manuals, training programs). + Identify… more
- St. Luke's Health System (Twin Falls, ID)
- …sources to provide and maintain a single reporting location that reflects clinical denials and appeals activity. + Recommends improvements and modifications to ... great place to work. **What You Can Expect:** Under limited supervision, the Clinical Appeals Specialist 2, is responsible for managing client medical denials by… more
- CommonSpirit Health (Englewood, CO)
- …denied claims to determine validity and identify opportunities for overturning inappropriate denials . Leads the appeals process by providing clinical expertise, ... the needs of patients and alternative levels of care. The PA performs denials management and prevention in accordance with the organization's goals and expectations.… 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
- RWJBarnabas Health (Oceanport, NJ)
- …Analyst, Appeals is primarily responsible for validating clinical and technical denials to ensure appeals are accurately pursued. Daily work includes ... Associate Analyst ARS, Appeals , Remote, NJReq #:0000175741 Category:No Category Assigned Status:Full-Time...ordering medical records, entering denials , and calling payers to gather account information as… 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
- 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
- Covenant Health Inc. (Knoxville, TN)
- …Business Office personnel to resolve issues related to claims, coding, pre-cert, and denials appeals , and verifies that appropriate chargemaster rates are used. ... and hospital personnel to ensure qualifying diagnosis covers tests/procedures. + Analyzes denials and coordinates appeals . + Ensures corrective action is taken… more
- Houston Methodist (Houston, TX)
- …services. This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in ... payer work queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits appeals when necessary. + Resolves… more
- UNC Health Care (Chapel Hill, NC)
- …to coder questions and provide training and education. This position processes and appeals insurance coding denials . This position analyzes coded records for ... surgery, and ancillary cases). 3. Faxes, tracks, and monitors coding denials and appeals on both inpatient and outpatient cases. Reviews coding insurance … more
- Hunterdon Health Care System (Flemington, NJ)
- …are accounted for within the master charge master file. + Tracks AR days, denials , appeals , and recommends policy and procedure changes to reduce and prevent ... for all hospital ancillary areas. Maintains best practices with registration, billing, denials , payment posting and collection follow up processes using HFMA data.… more
Related Job Searches:
Appeals,
Appeals Denials Coordinator,
Denials,
Denials Appeals Analyst,
Denials Appeals Manager,
Denials Appeals Representative,
Denials Appeals Specialist,
Director Clinical Denials Appeals,
Medical Appeals Denials Representative,
Medical Billing Denials Appeals