- HCA Healthcare (Ocala, FL)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? ... are a committed, caring group of colleagues. Do you want to work as a Clinical Denial Coding Review Specialist where your passion for creating positive… more
- Oracle (Tallahassee, FL)
- …your career in this exciting arena. We are looking for a Senior Claims Denial Prevention and Appeals Specialist for providing clinical inputs to engineering for ... Denial Prevention and Appeals features of Oracle Health Clinical AI Agent (CAA). This role leverages expert ...clinical validation) to lead the appeals initiative to review denied claims, create write-ups for appeals packets, identify… more
- Molina Healthcare (Tampa, FL)
- …review , long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with… more
- Prime Therapeutics (Tallahassee, FL)
- …staff and/or pharmacists. + Escalates requests to Pharmacist when request requires extensive clinical review or denial . + Monitors telephone system to ... Come build the future of pharmacy with us. **Job Posting Title** Clinical Pharmacy Technician Sr - Remote **Job Description** Evaluates and authorizes approval… more
- HCA Healthcare (Jacksonville, FL)
- …**What you will do in this role:** + Conduct reviews of charging, coding , and clinical documentation, collaborating with Corporate Revenue Integrity Leadership ... Submit your application for the opportunity below: Revenue Integrity Charge Review Analyst Parallon **Benefits** Parallon offers a total rewards package that… more
- Public Consulting Group (Tallahassee, FL)
- …other contractual deliverables when needed. Ensures accurate system support through review and updating reference data, contractual metrics, and compliance metrics. ... other contractual deliverables when needed. Ensures accurate system support through review and updating reference data, contractual metrics, and compliance metrics.… more
- Datavant (Tallahassee, FL)
- …to realize our bold vision for healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, ... review of admissions for medical necessity and necessity of...medical necessity criteria and standards of care, along with clinical knowledge and expertise successfully. Ideal candidate should be… more
- Cardinal Health (Tallahassee, FL)
- …Revenue Cycle Management manages a team focused on a series of clinical and administrative processes that healthcare providers utilize to capture, bill, and ... revenue cycle process. This includes, billing follow up, collections, payment posting, denial resolution, and responding to patient inquiries in a professional and… more
- HCA Healthcare (Ocala, FL)
- …+ Coordinate retrospective, concurrent, patient requested and external billing audits. + Review denial trends for documentation and charging opportunities. + ... balances. + Analyze accounts for specialized billing requirements that require a review of medical record documentation, regulatory information, and HCA standards. +… more
- Ascension Health (Jacksonville, FL)
- …the level of care and length of stay determination. + Assist and manage the denial management process. + Review and offer suggestions related to resources and ... appropriate utilization of alternate levels of care, community resources, clinical documentation improvement, coding , quality and/or compliance processes.… more