- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims ... or AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support… more
- University of Utah (Salt Lake City, UT)
- …Number** PRN40045B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA ... CPC -H), Certified Professional Coder-Payer ( CPC -P), Certified Coding Specialist ( CCS ), Certified ...of revenue cycle. + Working knowledge of insurance denials, appeals and expected reimbursement rates. + Experience presenting findings… more
- Glens Falls Hospital (Glens Falls, NY)
- …Emergency coding *Licenses, Certifications, Registrations* * o CCS, RHIT, RHIA, Certified Coding Specialist is Required o CDIP is a plus *Salary Range* The ... under law. **Job:** **Allied Health - Health Information Management* **Title:** * Coding Reimbursement Appeals Supervisor - Health Information Management (HIM)… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II...cases that require immediate clinical quality of care, initial coding of member grievance and evaluation and/or require immediate… more
- TEKsystems (Austin, TX)
- Description: Job Summary: The Revenue Cycle Denials and Appeals Specialist will be responsible for building and maintaining collaborative and productive ... Medical billing,Accounts receivable,Claim,Health care,Collection,Insurance,Medical claim,revenue cycle,medicare,insurance verification,accounts payable,denied claims, appeals ,revenue cycle management,medical terminology,medical billing and coding… more
- McLaren Health Care (Bay City, MI)
- …ACDIS memberships + Certified Medical Coder, Certified in Healthcare Compliance, Certified Coding Specialist , or Certified Clinical Documentation Specialist ... . Provides support to both internal and external customers for denial/ appeals activities and audits. Assists with monitoring and auditing activities, reviews… more
- Carle (Urbana, IL)
- Outpatient Denial/ Appeals Specialist - RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + ... documentation review to establish and manage clinical and prior authorization denial appeals for the Carle enterprise. Represents Carle in clinical meetings and… more
- TEKsystems (Charlotte, NC)
- Description: The Revenue Cycle Denials and Appeals Specialist will be responsible for building and maintaining collaborative and productive relationships within ... the designated revenue cycle function, with a focus on Denials and Appeals * Performs analysis, identifies trends, presents opportunity areas, and prioritizes… more
- 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 ... to billing, coding , and collection practices in compliance with federal and...systems + Review claim denials for clinical issues, prepare appeals , and manage each case's resolution process + Develop… more
- TEKsystems (Addison, TX)
- …to strengthen appeal arguments. Additional Skills & Qualifications: - Proven experience as an Appeals and or denials Specialist or in a similar role within a ... reimbursement issues to identify the root causes. - Initiate and manage the appeals and arbitration process for denied or underpaid claims, ensuring timely and… more
- CDPHP (Albany, NY)
- …values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and grievance ... Using knowledge of clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests, render determinations… more
- TEKsystems (Jackson, MS)
- Revenue Cycle/ Appeals Specialist Needed Description: 100% Remote Equipment Provided The Appeals Specialist 1, under the direction of the Director of ... and ancillary departments with all payer updates regarding billing and coding updates/changes, completes timely and consistently reports project status to leadership… more
- TEKsystems (Addison, TX)
- …out of network Additional Skills & Qualifications: - 3 + Proven experience as an Appeals Specialist or in a similar role within a healthcare setting. - ... reimbursement issues to identify the root causes. - Initiate and manage the appeals and arbitration process for denied or underpaid claims, ensuring timely and… more
- Hartford HealthCare (Farmington, CT)
- …Information Technician (RHIT), Registered Health Information Administratir (RHIA), Certified Coding specialist (CCS) and/or Certified Procedural Coder (CPC) ... to achieve greater efficiency and facilitate maximum mitigation efforts . Creates written appeals utilizing official coding guidelines, coding clinic, and… more
- Houston Methodist (Houston, TX)
- …& Denials Specialist is responsible for coordinating and monitoring the coding -specific clinical charges and denial management and appeals process in a ... and functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS**...Certified Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved… more
- Fairview Health Services (St. Paul, MN)
- …medical policies **License/Certification/Registration** One of the following: + Certified Coding Specialist -Professional (CCS-P) + Certified Professional Coder ... **Overview** The Physician Coding Denials Specialist performs appropriate efforts...medical records and coding guidelines to formulate coding arguments for appeals and/or coding… more
- HCA Healthcare (Nashville, TN)
- …and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts ... Bonus Eligible* Do you have the career opportunities as an Inpatient Coding Denial Specialist you want with your current employer? We have an exciting… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Coding Specialist position is responsible for applying correct coding conventions to patient charge encounters in a clinical ... in the electronic health record. In addition, the Sr Coding Specialist position is responsible for reviewing,...posting to the assigned work queues. + Investigates and appeals unpaid, denied and partially paid claims by third… more
- MetroHealth (Cleveland, OH)
- …opportunities to improve documentation accuracy. Reviews DRG downgrades and strategic CDI appeals , and responds to payor audits and inpatient downgrade requests when ... below. Minimum of 5 years as Clinical Documentation Integrity Specialist or; - CDIP or CCDS Certification with minimum...assignments (MS and APR). Current working knowledge of Official Coding Guidelines, Coding Clinic and federal updates… more
- Whitney Young Health Center (Watervliet, NY)
- Claims Coding Specialist (Req 100825) Watervliet, NY (http://maps.google.com/maps?q=1601+Broadway+Watervliet+NY+USA+12189) Apply Description GENERAL ... insurance types as designated by the Director. Reviews payer coding policies and procedures to ensure that the department...accordance with contracts, calling payers on open claims, sending appeals on denied claims and following up on requests… more