- BronxCare Health System (Bronx, NY)
- …best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials ... Overview The Appeals Manager is responsible to assist...to assist the department attain its objective of managing denials and appeals . Responsibilities -Types, utilizing a… more
- Garnet Health (Middletown, NY)
- …is responsible for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate ... overall quality, completeness, and accuracy of medical record documentation. The Manager will evaluate denials and work closely with the outcomes manager and… more
- Beth Israel Lahey Health (Plymouth, MA)
- …making a difference in people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth ... Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs...Reviews and determines appropriate strategy in response to reimbursement denials . + Responsible for appeals and follow… 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
- University of Washington (Seattle, WA)
- … denials to determine next steps. Additionally, they conduct appeals as appropriate by reviewing medical necessity, and/or reconciling coverage-related issues. ... thoroughly, and communicated payer decisions in a timely manner + Review clinical denials and initiate appeals process + Conduct medical necessity reviews, based… 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
- CenterWell (Denver, CO)
- …communication and presentation skills + Advanced knowledge with Payer requirements, ADR requests, Denials , Appeals , RAC/ZPIC and CERT responses + Must be able to ... community and help us put health first** The Director Denials Management provides leadership for the audit, appeal and...and appeal process. The Director, Home Health Grievances & Appeals assists members, via phone or face to face,… more
- Guthrie (Sayre, PA)
- …Audit Manager is responsible for the oversight and management of all payer denials , appeals , and audit processes within the health system. This role ensures ... or insurance with responsibility and management of billing and reimbursement. Essential Functions Denials & Appeals Management + Oversee daily operations of the … more
- NTT America, Inc. (Plano, TX)
- …and forward-thinking organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is seeking to hire a **Medicare ... Appeals Clinical Leader** to lead service delivery engagements and...interpret medical records, documenting recommendations to uphold or overturn denials + Excellent analytical and problem-solving skills + Strong… more
- HCA Healthcare (Nashville, TN)
- …requests for intervention from the centralized peer-to-peer team and others regarding denials and appeals processes, observation level of care, decisions about ... have the career opportunities as a Quality Control Senior Manager you want with your current employer? We have...and address payer medical policies that lead to inappropriate denials , advocating for fair and accurate coverage. + Provide… 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)
- …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
- Fallon Health (Worcester, MA)
- …regarding the grievance/appeal. + Acts as the initial investigator for provider appeals related to filing limit, claim denials , claim payment, retrospective ... on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with… more
- Sharp HealthCare (San Diego, CA)
- …with providers.Provide advice to Revenue Cycle/HIM regarding RAC decision to appeal, denials , input into appeals , share findings with providers.Review all cases ... Day **FTE** 1 **Shift Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); Bachelor's Degree in Nursing;… more
- Sharp HealthCare (San Diego, CA)
- …with providers.Provide advice to Revenue Cycle/HIM regarding RAC decision to appeal, denials , input into appeals , share findings with providers.Review all cases ... 1 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager ...organization goals including reductions in length of stay, decreasing denials , improvement of care transitions, and reduction in avoidable… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …Office is opened daily and comments are entered in the system for authorization, denials and EOB's timely, scanned in DoclLnk and filed in monthly Business Office ... folder. + Discuss denials with UR staff and update Denial Tracker accordingly....prepare patient or insurance refund. + Request charts, prepare appeals and charts for mailing, documenting Denial Tracker in… more
- Crouse Hospital (Syracuse, NY)
- …Care Managers in the department, including Utilization Management, Discharge Planning and Denials and Appeals functions. + Assessing workflow related to ... and outreach programs. Crouse's Care Coordination team is hiring a Care Coordination Manager who is responsible for providing day to day management of the RN… more
- Highmark Health (Monroeville, PA)
- …and contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials / appeals and retrospective payer audit denials . ... CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association - American Case Management… more
- HCA Healthcare (Tallahassee, FL)
- …**Introduction** Are you ready to manage in a new era as a Front Office Manager where building a healthier tomorrow is more than a job? Our HCA Florida Capital ... Healthcare facility. Be an impact as a(an) Front Office Manager where your passion for leading and creativity are...make notes regarding payment.** 1. **Reviews daily preservice log, appeals inventory, and write-offs on a daily basis, reports… more
- Robert Half Finance & Accounting (Bennington, VT)
- …contracts, recommend procedural changes, and train staff accordingly. + Manage technical denials process, including appeals and carrier communication. + Produce ... About the Role Our client is seeking an experienced Hospital Billing Manager to lead patient accounts receivable operations and ensure accurate, timely billing… more