- TEKsystems (Addison, TX)
- …to strengthen appeal arguments. Additional Skills & Qualifications: - Proven experience as an Appeals and or denials Specialist or in a similar role ... processes, claim adjudication, and reimbursement methodologies. - Familiarity with insurance denials , appeals , and arbitration processes, including knowledge of… 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
- Hartford HealthCare (Farmington, CT)
- …Records / Health Information* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 2 / HIM Coding* **Location:** ... for the development and implementation of an effective HIM Coding denials program consistent with regulatory and healthcare revenue cycle industry standards.… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial ... functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** +...Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved Specialty Society Coding… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... and rejections. + Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and impact on revenue and trending. +… more
- AdventHealth (Altamonte Springs, FL)
- …contribute:** This position is responsible for investigating and appealing post-remit denials for all Inpatient and Outpatient clinical services across the system, ... best opportunity for fair reimbursement. The Clinical Denial Management Specialist will adhere to the AHS Compliance Plan and...you bring to the team:** . Reviewing and appealing denials for all clinical services across the AH system… more
- Insight Global (Skokie, IL)
- Job Description Insight Global is looking for a clinical denials specialist to join the team at one of your healthcare clients in Chicago. As a Clinical ... Denials Specialist you will be working with...Denials Specialist you will be working with the ...clinical perspective. This person will be responsible for preparing appeals and communication with the clinical team members. 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 ... executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES & ESSENTIAL JOB...Management team when cases do not meet criteria; coordinates denials with the attending physician and the Care Management… more
- UCLA Health (Los Angeles, CA)
- …commitment to accuracy and quality in claim processing. As an Audit and Appeals Specialist , you will: + Facilitate responses to regulatory audits related ... maintaining updated records in various systems + Review claim denials for clinical issues, prepare appeals , and...Review claim denials for clinical issues, prepare appeals , and manage each case's resolution process + Develop… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... or AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and… more
- TEKsystems (Glen Burnie, MD)
- …coding is accurate and documentation supports reimbursement. 3. Analyzes coding-related denials (for problems such as bundling issues and inappropriate 4. ... CPT/diagnoses) to identify trends and root causes. 5. Develops process improvements for coding and documentation workflows based on denial analysis and industry coding guidelines. 7. Organizes data into clear reports that are presented to denial management… more
- TEKsystems (Odenton, MD)
- …coding is accurate and documentation supports reimbursement. + Analyzes coding-related denials (for problems such as bundling issues and inappropriate. + ... CPT/diagnoses) to identify trends and root causes. + Develops process improvements for coding and documentation workflows based on denial analysis and industry coding guidelines. + Organizes data into clear reports that are presented to denial management… more
- Houston Methodist (Houston, TX)
- …This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the ... At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect...queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits… more
- Priority Health Care (Marrero, LA)
- …also involves ensuring timely response from third-party payors, processing payor denials , documentation requests, and appeals , and monitoring day-to-day ... activities related to appeal follow-up and denials . Additionally, the Specialist is responsible for...by the manager in a timely manner. + Write appeals using established guidelines to resolve claim denials… more
- Hartford HealthCare (Farmington, CT)
- …and homecare to insure optimal revenue cycle performance. The AR Follow Up & Denials Specialist is responsible for resolving unpaid third party balances on $550 ... million in active inventory and $70 million in denials through account follow up, appeals and resubmission actions. This position reports directly to the AR… more
- Baptist Memorial (Memphis, TN)
- …debt from potential write-offs due to lack of collections and overturns on payer denials through the appeals process. The role will collaborate with upper ... Summary The Denial Mitigation Specialist - Denial Escalation Quality Assurance evaluates the...Baptist aging AR + Prepare and submit reconsiderations and appeals to timely filing denials and follow… more
- HCA Healthcare (Nashville, TN)
- …and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts ... your knowledge and expertise! **Job Summary and Qualifications** The Inpatient Coding Denials Specialist is a high-level coding expert responsible for… more
- Beth Israel Lahey Health (Danvers, MA)
- …lives.** Identifies, reviews, and interprets third party payments, adjustments and denials . Initiates corrected claims, appeals and analyzes unresolved third ... + Assists the Billing Supervisor with the resolution of complex claims issues, denials , appeals and credits. + Works with cash team to resolve unapplied cash. +… 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 ... of the unique communities we serve. Summary: The Government-Non-government Specialist is responsible for reviewing, submitting and resolving assigned insurance… more
- Johns Hopkins University (Middle River, MD)
- …payments. The Specialist will research and interpret medical policies regarding denials based on medical necessity. Will use a working knowledge of local ... We are seeking an **_AR revenue Cycle Specialist II_** who will be responsible for the...+ Resolves claim edits. + Drafts and resolves non-standard appeals . + Researches medical policies to resolve denials… more
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