- US Physical Therapy (Houston, TX)
- …Pricing rationale + Maintain and update pricing annually for new CPT Codes + Review denial trends + Financial Class determination + Update Medicare Expected ... nationwide, across 44 states, offering them the resources, operational support, and clinical expertise needed to thrive in today's healthcare landscape. By aligning… more
- Olympus Corporation of the Americas (Center Valley, PA)
- …**Job Duties** + Daily engagement with US hospital and office administrators to review coding and payer coverage policies and decisions to enable physician ... + Educate customers (physicians, purchasers, etc.) on reimbursement, coverage, coding , and Medicare payments. + Influence the purchasing and/or reimbursement… more
- HCA Healthcare (Plano, TX)
- **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
- Hartford HealthCare (Farmington, CT)
- …**Key Areas of Responsibility** * Denial Resolution* . Conduct a thorough review of medical records, coding and clinical documentation to ... to DRG (Diagnostic Related Group) downgrades. This role involves validating the coding and clinical accuracy, ensuring proper documentation and collaborating… more
- Oracle (Little Rock, AR)
- …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
- Health Plus Management LLC (Uniondale, NY)
- …functions for our family of companies.Duties & Responsibilities: + Manage timely review , investigation and response to coding denials + Determines actions ... Denial Management Associate Location Uniondale Description Health Plus...is a Physician Support Organization and market leader in clinical practice management in the physical medicine and rehabilitation… more
- Hartford HealthCare (Farmington, CT)
- … reasons, and determine the appropriateness of the initial coding and clinical documentation. . Conduct a thorough review of medical records, coding ... outline the rationale for overturning the denial , referencing official coding guidelines (ICD-10-CM/PCS), payer policies, and clinical standards. . Work… more
- Fairview Health Services (St. Paul, MN)
- …Collaborates with Clinical Denials Nurse Specialist and Leadership in high-dollar claim denial review and addresses the coding components of said claims. ... denials. + Compiles training material and educational sessions associated with coding denial -related topics and presents such educational materials.… more
- University of Southern California (Alhambra, CA)
- …both IP & OP healthcare services provided to covered patients. Manages the denial management process for coding -related denials, triage denied claims to ... distinguish coding -related denials versus clinical -related denials, evaluating claims deemed inappropriately paid by the...need for appeal. Performs all 1st and 2nd level coding -related denial appeals. All tasks & duties… more
- Carle Health (Champaign, IL)
- …providers, clinical staff and coders. + Serves a point of contact for clinical coding inquiries. + Demonstrate the attention to detail to minimize coding ... team, the Manager over Coding Education and Quality collaborates with coding managers and clinical documentation integrity manager to ensure excellence in… more
- Tufts Medicine (Burlington, MA)
- …creation of deficiencies, within Epic, for missing documentation. Works with leadership to review denial reports as well as participating in internal and ... focuses on support of daily business activities (eg, technical, clinical , non- clinical ) operating in a "hands on"...leadership to identify discrepancies. 5. Reviews audit lists regarding coding /billing changes, as well as denial reports.… more
- Hartford HealthCare (Farmington, CT)
- …as needed. This position is responsible for assisting Revenue Cycle Services, Coding , Clinical Documentation Improvement (CDI), and other departments with ... of Responsibility* 1) This position is responsible for assisting Revenue Cycle Services, Coding , and other clinical departments with resolution of billing issues… more
- Rush University Medical Center (Chicago, IL)
- …EMR charge capture support. 7. Serves as a liaison point of contact for clinical coding inquiries and communication for professional billing revenue cycle 8. ... Provide feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding , and implement corrective action… more
- Catholic Health Initiatives (Omaha, NE)
- …capture, clinical documentation including Electronic Health Record (EHR) requirements, coding accuracy and denial management to clinicians and clinic staff. ... coding improvement, and revenue capture. Developes and presents Coding and ducmentation training to clinicians, clinical ...is needed. Essential Function + Acts as documentation and coding liaison to clinicians to include review ,… more
- Hartford HealthCare (Farmington, CT)
- …departments and processes corrections for clean claim submission or posts claim denial review for appeal. *Communication* 1. Seeks clarification from physicians ... * Coding * *Applies strong knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to determine… more
- Huron Consulting Group (Chicago, IL)
- …across multiple specialties (eg, Inpatient, E&M, Ambulatory, Surgery, Cardiology, Radiology), including denial review and appeals. + 2+ years of experience as ... and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient...now and create your future. Job Description Summary The Coding Integrity Specialist will be responsible for executing a… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …coding inventories. Coordinates with vendor quires and questions related to assigned multi-specialty coding inventories. + Review ETM coding denials for ... coding training programs, educational handouts/materials, FAQs, etc. for physicians/providers, coding staff and clinical department administrators. + Assist… more
- University of Virginia (Charlottesville, VA)
- …record systems, or based on paper documentation. + Monitors, analyzes, and resolves charge review , claim edit, and coding -related denial trends and shares ... based on findings/resolution of errors. + Manages assigned charge review and coding -related claim edit work queues...High School Diploma or GED Experience: Five years of coding / clinical experience with training in 1-3 specialties… more
- Texas Health Resources (Arlington, TX)
- …coding education, training, and best practices for areas vulnerable to compliance errors. Denial Support & Case Review - Conduct additional reviews to assist ... organizational policies. Evaluate the effectiveness of internal controls and compliance procedures. Coding & Documentation Review - Assist the audit team with… more
- Atlantic Health System (Morristown, NJ)
- Responsible for coding quality audits of all records (outpatient, inpatient, procedures, testing) to assure appropriateness and accurate code assignments in ... for the providers and staff; also responsible for assisting with coding inquiries from providers, charge posters, billing staff, etc. Principal Accountabilities:… more
