• Clinical Denials & Appeals

    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
    Northwell Health (01/05/25)
    - Save Job - Related Jobs - Block Source
  • Remote Medical Appeals Specialist

    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
    Community Health Systems (01/08/25)
    - Save Job - Related Jobs - Block Source
  • Revenue Cycle Coding Supervisor - Appeals

    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
    University of Michigan (01/03/25)
    - Save Job - Related Jobs - Block Source
  • Coding Charges & Denials Specialist

    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
    Houston Methodist (01/06/25)
    - Save Job - Related Jobs - Block Source
  • Denials Specialist 2 / HIM Coding

    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 (11/06/24)
    - Save Job - Related Jobs - Block Source
  • Denials Specialist 1 / HIM Coding

    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
    Hartford HealthCare (12/06/24)
    - Save Job - Related Jobs - Block Source
  • Denials Management Specialist , Full…

    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
    St. Luke's University Health Network (12/28/24)
    - Save Job - Related Jobs - Block Source
  • Denials Management Specialist Remote

    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
    AdventHealth (01/09/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Denials Specialist

    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
    Insight Global (01/03/25)
    - Save Job - Related Jobs - Block Source
  • Specialist , Appeals & Grievances

    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
    Molina Healthcare (01/08/25)
    - Save Job - Related Jobs - Block Source
  • Care Management Clinical Appeals

    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
    Alameda Health System (11/19/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Appeals Specialist II - RN…

    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
    Community Health Systems (01/08/25)
    - Save Job - Related Jobs - Block Source
  • Audit and Appeals Specialist

    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
    UCLA Health (11/06/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Appeals Specialist

    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 Health System (01/08/25)
    - Save Job - Related Jobs - Block Source
  • Coding Appeals Specialist

    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
    St. Luke's University Health Network (11/09/24)
    - Save Job - Related Jobs - Block Source
  • Coding Appeals Analyst

    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
    TEKsystems (01/07/25)
    - Save Job - Related Jobs - Block Source
  • Revenue Cycle Specialist - Plastics…

    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
    Houston Methodist (12/21/24)
    - Save Job - Related Jobs - Block Source
  • Revenue Cycle Specialist II

    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
    Priority Health Care (10/24/24)
    - Save Job - Related Jobs - Block Source
  • Collections Specialist / PA Third Party…

    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
    Hartford HealthCare (12/31/24)
    - Save Job - Related Jobs - Block Source
  • PB AR Revenue Cycle Specialist II

    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
    Johns Hopkins University (12/20/24)
    - Save Job - Related Jobs - Block Source