- R1 RCM (Salt Lake City, UT)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals and Denials Manager ** , you will serve ... denial management. **Here's what you will experience working as a Clinical Appeals and Denials Manager ** + Responsible for the oversight of department… 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 ... of coding quality goals and outcomes + Collaborate with Manager and Medical Coding Compliance Specialists to review training...ID** 258393 **Working Title** Revenue Cycle Coding Supervisor - Appeals & Denials **Job Title** Revenue Cycle… more
- Hartford HealthCare (Farmington, CT)
- …for the development and implementation of an effective HIM Coding denials program consistent with regulatory and healthcare revenue cycle industry standards. ... collecting data to monitor progress. *_Position Responsibilities:_* *Key Areas of Responsibility* * Denials Resolution* . Manages the HIM Coding Denial work queue and… more
- Hartford HealthCare (Farmington, CT)
- …programs and other common practices across the system. *_JOB SUMMARY_* The Denials Specialist 1 is responsible for HIM Coding denial resolution and prevention ... Communicates and educates on any identified coding denial trends. *_JOB RESPONSIBILITIES_* * Denials Resolution* * Works with coding staff to investigate and resolve… more
- AdventHealth (Altamonte Springs, FL)
- …identifying variance causes for the identification and resolution of payer denials and expected reimbursement underpayments. Responsible for recognizing payer trends ... are equally respectful to all. Under general supervision of the Supervisor of Denials Management, will be responsible for billing and A/R follow up, denial recovery,… more
- Guidehouse (Birmingham, AL)
- …to resolve claim denials and account balances. + Performing Non-Clinical Appeals . + Assisting Supervisor/ Manager as needed with various projects. + Escalate ... expert can effectively resolve the matter. + Communicate to Supervisor/ Manager areas of concern or areas of improvement. +...+ 0-2 years medical provider experience working with UB04, appeals & denials . **What Would Be Nice… 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
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE: The… more
- St. Luke's University Health Network (Allentown, PA)
- …to, physicians, hospital employees and vendors. Advises Network CDI & DRG Denials Manager on issues requiring immediate attention. ADDITIONAL REQUIREMENTS: ... regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of… 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 ... Supervisor. + Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further...queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits… 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 ... and ancillary cases). 3. Faxes, tracks, and monitors coding denials and appeals on both inpatient and...software (eg Optum, Epic, PWC SMART, MS Office, Audit Manager etc.) to compile and validate medical information. **Other… more
- Priority Health Care (Marrero, LA)
- …AR work lists provided by the manager in a timely manner. + Write appeals using established guidelines to resolve claim denials with a goal of one contact ... also involves ensuring timely response from third-party payors, processing payor denials , documentation requests, and appeals , and monitoring day-to-day… 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
- 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
- UTMB Health (Galveston, TX)
- …under Revenue Cycle Operations (RCO) including team leads and specialists ( denials /follow-up). The Manager interacts with UTMB leadership, including clinical ... Manager , Hosp/Professional Ins Follow Up - Revenue Cycle...Responsible for timely and accurate account resolution, including payer appeals for all denials and underpayments. +… more
- Houston Methodist (Houston, TX)
- …verbal and written communication. + Identifies denial trends and notifies supervisor and/or manager to prevent future denials and further delay in payments. ... services. This position performs collections activities on simple and complex denials and on outstanding insurance balances in the professional fee environment.… more
- Johns Hopkins University (Middle River, MD)
- …and insurance) as needed. + Resolves claim edits + Drafts and resolves non-standard appeals . + Researches medical policies to resolve denials based on medical ... coding. + Demonstrated experience resolving third-party payor insurance processing issues, including appeals and denials . + Ability to perform on-line research… more
- Surgery Care Affiliates (Boise, ID)
- …Effectively and independently handles second level reimbursement issues, contracted and non-contracted denials for serviced before and after procedures. + Works all ... denials and corrected claims collaborating with the biller and/or Business Office Manager , insurance payers and/or patients on past due accounts. + Follow center… more
- UNC Health Care (Goldsboro, NC)
- …legal, and compliance guidelines Processes all assigned government and nongovernment accounts and denials for complex financial appeals , with a goal of bringing ... with regulatory, legal, and compliance guidelines. Follows rules for overturning appeals and rejections for these accounts. Completes additional research and… more
- Beth Israel Lahey Health (Burlington, MA)
- …Billing Office. 20. Independently works on the resolution of complex claims issues, denials and appeals . 21. Completes projects and research as assigned. 22. ... involve registration error, coverage and eligibility related front-end edits and denials for both Professional and Hospital Billing. Additional tasks for… more