- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ... with CMS requirements, guidelines, and standardized published criteria to support the medical necessity of patient admission and continued hospital stays. This role… more
- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ... with CMS requirements, guidelines, and standardized published criteria to support the medical necessity of patient admission and continued hospital stays. This role… more
- Community Health Systems (Franklin, TN)
- …1-3 years of experience in medical billing, revenue cycle, or claims denials and appeals processing required + Prior experience with revenue cycle processes ... **Job Summary** The Denials & Appeals Coordinator is responsible...Skills and Abilities** + Strong knowledge of payer guidelines, medical billing practices, and appeal processes. + Proficiency in… more
- Nuvance Health (Danbury, CT)
- …*Summary:* Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician Advisors (PAs) and other stakeholders ... Assists in timely sorting and dissemination of requests for medical information from insurers and other sources to the...appeals , denial and clinical reviews 9. Reviews new denials and appeal upheld cases in work queue and… more
- Northwell Health (Melville, NY)
- …the third party payer. + Prepares and defends level of care and medical necessity for assigned case. + Collaborates with physician advisor, payor representative and ... + Performs concurrent and retrospective utilization management using evidenced-based medical necessity criteria; conducts clinical reviews and formulates appeal… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... to make appropriate decisions and is accountable for reviewing denials for level of care, medical necessity,...and denials for no authorization. The Senior Denials Management Specialist position communicates clinical information… more
- University of Southern California (Alhambra, CA)
- …federal & state coding compliance regulations and guidelines, the HIM Coding Denials Management Specialist " analyze, investigate, mitigate, and resolve all ... addition, this position will provide guidance and training to other HIM Coding Denials Management Specialist , and will assist with escalated issues. Essential… more
- Fairview Health Services (St. Paul, MN)
- **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by the ... pertaining to billing, coding, and documentation. The Inpatient Coding Denials Specialist will also handle audit-related and...appeals or re-billing of claims to resolve coding denials to ensure collection of expected payment and mitigation… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Medical Billing & Denials Specialist Department: Patient Financial ServicesLocation: Massena HospitalHours Per Week: 40Schedule: Monday - Friday ... 8AM-4PM SUMMARY: A Medical Billing and Denials Specialist ...fee schedules, DRGs, and reimbursement procedures. + Claims and Appeals Processing: Submits and follows up on insurance claims;… 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 Resolution Specialist is responsible for resolving...the integrity of all account documentation; maintains confidentiality of medical records. + Identifies potential trends in denials… more
- BJC HealthCare (St. Louis, MO)
- …Responsible for resolving clinical denials for BJC hospitals and payors. The Clinical Appeals Specialist must be able to multi-task and maintain a high level ... About the Role** BJC HealthCare is seeking a Clinical Appeals Specialist to assist with infusion .... Collaborates to develop best practices procedures to prevent denials . + Effectively communicates with the Clinical Appeals… more
- Robert Half Office Team (Carmel, IN)
- Description Our team is seeking a detail-oriented Medical Denials Specialist to join a fast-paced healthcare environment and ensure accurate, timely ... payers to facilitate claim resolution. + Prepare and submit appeals and supporting documentation as needed. + Collaborate with...related field preferred. + Minimum 2 years' experience in medical billing, denials management, or health insurance… more
- McLaren Health Care (Mount Pleasant, MI)
- …responsibilities of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and ... appeals demonstrating accuracy/proficiency in referencing support from the medical recorddocumentation and coding guidelineswith timely and successful submissions.… 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 ... leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across… more
- HCA Healthcare (Brentwood, TN)
- …purpose and integrity. We care like family! Jump-start your career as an Appeals Specialist today with Parallon. **Benefits** Parallon offers a total rewards ... vary by location._** Come join our team as an Appeals Specialist . We care for our community!...for reconsideration. + Identify contract protection to leveraged overturn denials . + Argue appeals that prevent claim… more
- UNC Health Care (Kinston, NC)
- …Advisor and Case management Assistants. 4. Reviews and documents findings on all medical necessity and status denials . 5. Works closely with Patient Financial ... the team in the strategy to appeal all clinical denials . Provides the clinical expertise to draft the first...Advisors and subject matter experts for all audit and appeals work activities. Assists with documentation review to support… more
- Molina Healthcare (Tampa, FL)
- …appropriate appeals and grievance outcomes. * Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per ... subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and ... needed for workflow or identification of trends. Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and… more
- TEKsystems (Addison, TX)
- …medical biller,anesthesia Additional Skills & Qualifications - Proven experience as an Appeals Specialist or in a similar role within a healthcare setting. ... processes, claim adjudication, and reimbursement methodologies. - Familiarity with insurance denials , appeals , and arbitration processes, including knowledge of… more
- TEKsystems (San Bernardino, CA)
- …Management team. In this role, you will play a critical part in managing clinical denials related to medical necessity, level of care, DRG revisions, and delays ... + Strong clinical knowledge and ability to interpret complex medical records. + Experience in clinical appeals ,...complex medical records. + Experience in clinical appeals , utilization review, or revenue cycle management. + Excellent… more
Related Job Searches:
Appeals,
Appeals Specialist,
Denials,
Denials Appeals Specialist,
Denials Specialist,
Medical,
Medical Appeals Specialist,
Specialist