- Sanford Health (Sioux Falls, SD)
- …of documentation, interpretation of policies, and handling of correspondence related to denials and appeals submitted by providers and members. Must administer ... a demonstrated understanding of regulatory requirements and timeframes. Intake and coordinate appeals and denials , and then make determinations based on member… more
- TEKsystems (Plano, TX)
- Required: + 2+ years of Insurance follow-up, denials / appeals experience (Medical A/R) + Hospital/facility collections experience Description: Responsible for ... Responsible for managing CBO Aging Report properly to insure appeals are followed up timely to prevent past filing...Responsible for timely medical records requests and submission of appeals * Maintain adequately trained staff to achieve daily… more
- Northwell Health (Melville, NY)
- …as needed. Preferred Skills + Prior experience in Case Management, Denials / Appeals and/or Utilization Review.*Additional Salary DetailThe 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
- Trinity Health (Farmington Hills, MI)
- …Payment Resolution with communication and follow-up processes related to rejections, denials and appeals , ensuring that such activities are tracked, ... Work Remote Position (Pay Range: $34.9314-$52.3971) Responsible for reviewing all post-billed denials (inclusive of clinical denials ) for medical necessity and… more
- Trinity Health (Farmington Hills, MI)
- …activities as part of the payment resolution team that receives, analyzes, and appeals denials received for an assigned PBS location. Reviews, researches and ... Business Services (PBS) location. The scope of responsibility will be all post-billed denials (inclusive of clinical denials ). Serves as part of the Payment… more
- Trinity Health (Farmington Hills, MI)
- …Remote Position (Pay Range: $20.6822-$31.0233) Responsible for reviewing all post-billed denials (inclusive of coding-related denials ) for coding accuracy and ... at a PBS location responsible for identifying and determining root causes of denials . Responsible for leveraging coding knowledge and standard procedures to track … more
- Trinity Health (Farmington Hills, MI)
- …Maintains knowledge of state/federal laws as they relate to contracts and the appeals process. Assists in training Payment Resolution Specialist I colleagues ... location. The scope of responsibility will be all post-billed denials (inclusive of clinical denials ). Serves as...as to ensure timely follow-up and action for account appeals . + Works with Patient Access and other necessary… 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
- Robert Half Accountemps (Long Beach, CA)
- … Specialist will be tasked with following up with insurance rendered regarding denials and rejections. The Medical Collections Specialist must be well versed ... detail? This growing company is hiring a Medical Collections Specialist with strong behavioral health skills. The Medical Collections...insurance companies and patients for request for payment - Appeals and denials management - Contacting and… more
- University of Utah (Salt Lake City, UT)
- …Number** PRN38907B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt ... -H), Certified Professional Coder-Payer ( CPC -P), Certified Coding Specialist ( CCS ), Certified Coding Specialist ...knowledge of revenue cycle. + Working knowledge of insurance denials , appeals and expected reimbursement rates. +… more
- SSM Health (MO)
- …**Job Highlights:** We are seeking a highly skilled and detail-oriented Coder for Hospital Denials to join our team at SSM Health. You will be responsible for ... reviewing medical records and accurately coding diagnoses and procedures for hospital denials . This role requires strong analytical skills, attention to detail, and… more
- Molina Healthcare (Milwaukee, WI)
- …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
- University of Virginia (Charlottesville, VA)
- …analyzes accounts receivable and takes appropriate action to resolve coding and global denials . + Posts denials /rejects into EPIC billing system. + Works complex ... denials with a high degree of accuracy and timeliness. Responds to inquiries from patients, clinical departments, and third parties by way of telephone, written correspondence and personal contacts. + Adds/corrects registration, insurance, and demographic… 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
- 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
- Beth Israel Lahey Health (Charlestown, MA)
- …of America) 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. 17. Works with cash team to resolve unapplied cash.… more
- Beth Israel Lahey Health (Charlestown, MA)
- …of America) 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. 17) Works with cash team to resolve unapplied cash.… more
- Beth Israel Lahey Health (Burlington, MA)
- …Billing Office. 15. Independently works on the resolution of complex claims issues, denials and appeals . 16. Completes projects and research as assigned. 17. ... you're making a difference in people's lives.** The Billing Specialist role specializes in high dollar claims, aged claims...complex specialties. This role identifies and works to resolve denials to uncover root cause and accurately appeal claims… more
- Johns Hopkins University (Middle River, MD)
- …and insurance) as needed. + Resolves claim edits. + Drafts and resolves non-standard appeals . + Research medical policies to resolve denials based on medical ... We are seeking a **_AR Revenue Cycle Specialist II_** responsible for the collection of unpaid...Demonstrated experience resolving third-party payor insurance processing issues, including appeals and denials . + Ability to perform… more
- Beth Israel Lahey Health (Burlington, MA)
- …15. Assists the Billing Supervisor with the resolution of complex claims issues, denials and appeals . 16. Completes projects and research as assigned. 17. ... Identifies, reviews, and interprets third party payments, adjustments and coding denials for all professional services. Reviews provider documentation in order to… more