- 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
- 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 ... flexible scheduling, 401k and student loan repayment programs. The Remote Medical Denials / Appeals Specialist position is remote and full time, which is… 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 ... (CPC), Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) credentials is required + Minimum of 2...ID** 258393 **Working Title** Revenue Cycle Coding Supervisor - Appeals & Denials **Job Title** Revenue Cycle… 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
- 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
- Hartford HealthCare (Farmington, CT)
- …recognition programs and other common practices across the system. *_JOB SUMMARY_* The Denials Specialist 1 is responsible for HIM Coding denial resolution and ... **Job:** **Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 1 / HIM Coding* **Location:**… 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)
- …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
- 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
- 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
- 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
- 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
- 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 Health System (Twin Falls, ID)
- …great place to work. **What You Can Expect:** Under limited supervision, the Clinical Appeals Specialist 2, is responsible for managing client medical denials ... sources to provide and maintain a single reporting location that reflects clinical denials and appeals activity. + Recommends improvements and modifications to… 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 (Annapolis, MD)
- …Schedule : Monday - Friday (Normal Business Hours) Position Summary: As a Coding Appeals Specialist , you will be a crucial member of the denial management ... Hybrid Coding Appeals Analyst Opportunity to join one of Maryland's...as well as suggesting process improvements to reduce future denials . Benefits: + Exposure : Ability to join and… 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
- 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 **_PB_** **_AR Revenue Cycle Specialist II_** responsible for the collection of unpaid...+ Resolves claim edits + Drafts and resolves non-standard appeals . + Researches medical policies to resolve denials… more
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