- NTT America, Inc. (Plano, TX)
- …adaptable, 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 communication and… more
- Houston Methodist (Katy, TX)
- …to: medical coding, insurance billing, collections, patient account resolution, appeals / denials , customer service, cash applications, revenue integrity, etc. ... At Houston Methodist, the Manager Revenue Cycle position is responsible for the...limited to the following: accounts receivable days, cash collections, denials , avoidable write-offs, staff productivity and work quality and… more
- Community Health Systems (Franklin, TN)
- …ensures efficient and effective management of utilization review processes, including denials and appeals activities. This role collaborates with payers, ... improvement initiatives, and serves as a key liaison to reduce denials and optimize patient outcomes. Essential Functions Submits initial assessments, continued… more
- Beth Israel Lahey Health (Charlestown, MA)
- …effective resolution of denied claims with the purpose of reducing overall denials and increasing revenue. This includes interpreting payment and denial data down ... be appealed. Responsible for writing timely, comprehensive and compelling appeals to third party payers in order to get...Performs ongoing analysis to determine the root cause of denials and makes well thought out recommendations for workflow,… more
- UnitedHealth Group (Scottsdale, AZ)
- …of charge capture patient encounters, co-payment collections, accounts receivable, denials , cash collections and credit/refunds. Develops reporting mechanisms to ... to, access, coding, billing, collections, practice management systems, payer relations, appeals , and authorization process Driver's License and access to reliable… more
- Community Health Systems (Franklin, TN)
- …management policies. This role conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers ... insurance companies to secure coverage approvals and mitigate concurrent denials by submitting reconsiderations or coordinating peer-to-peer reviews. Communicates… more
- Baylor Scott & White Health (Dallas, TX)
- …file handling Responsibility for the preparation of summaries and files for denials , appeals , medical opinions, subrogation and litigation.1. Collection of ... Under the direct supervision of the Safe Choice Claims Manager the Claims Adjuster is responsible for the review,...and Coordinate training with HR team4. Work with Claims Manager for improvements in processes to increase proficiency and… more
- Rush University Medical Center (Chicago, IL)
- …letters to Managed Care payers and submit charts when needed with these appeals . Works with Rush University Medical Center and Rush Oak Park Hospital departments ... works with their staff to identify rationale and resolve denials . Manages assigned work queues in Epic. Assigns cases...for resolution of escalated issues internally. Escalates issues to manager or payers as needed. Documents activity in all… more
- UnitedHealth Group (Dallas, TX)
- …Responsibilities: Responsible for the accurate processing and completion of medical claim denials and appeals . Work according to Standard Operating Procedures. ... while maintaining quality standards. Escalates issues to their Team Leader or Manager appropriately. Special projects as required. You'll be rewarded and recognized… more
- Option Care Health (Phoenix, AZ)
- …Assists with Billing and Collection Training and completes "second level" appeals to payers. Job Description: ? Job Responsibilities: Submits timely, accurate ... are mailed within 48 hours of receipt of payment. Notifies the Reimbursement Manager if there are overpayments and/or duplicate payments for the same service.… more
- 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
- Hartford HealthCare (Farmington, CT)
- …review of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials , ... multiple denials , prioritize tasks, and ensure timely submission of appeals . . Experience with electronic health record (EHR) systems, coding software, and… 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,...appeal. Performs all 1st and 2nd level coding-related denial appeals . All tasks & duties to be perform in… 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
- 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
- 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
- Omaha Children's Hospital (Omaha, NE)
- …management for insurance and government collections to include claims, A/R follow-up, denials and appeals . This includes supervising, monitoring, and analyzing ... **Schedule: FT, Days, denials exp required (flexible hours)** At Children's Nebraska,...policies, regulatory, and legal requirements. + Assisting the department manager in the implementation of the strategic direction within… 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
