- The University of Vermont Health Network (Elizabethtown, NY)
- …guidelines, and quality issues related to utilization management with application for appeals and denials management. * Knowledge of team/small group principles ... and dynamics* Demonstrates strong communication (verbal & written) skills and ability to engage and provide education to various sized groups and audience. * Demonstrates a desire to build honest and trustworthy relationships with all individuals.* Exhibits an… 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
- 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
- R1 RCM (Detroit, MI)
- …initial reviews, calling insurance companies to resolve authorization and clinical claim denials , writing appeals and letters to insurance companies to resolve ... denials , following up on appeals to the point of exhaustion or payment and...appeals and other correspondence to payers to overturn denials or resolve payer delay with writing skills being… more
- Robert Half Accountemps (Cincinnati, OH)
- …and managing billing processes for a healthcare facility, with a focus on claim denials and appeals . The employment type for this role is temporary. ... a unique opportunity in the healthcare industry for a Denials Specialist located in Cincinnati, Ohio. This role involves...or in a similar role * Proficiency in handling appeals and claim administration * Experience in working with… more
- HCA Healthcare (Largo, FL)
- …as appropriate. Contact the facilities, physician offices, and insurance companies to resolve denials and appeals . What qualifications you will need: High School ... of related experience required in the following area(s) required: appeals , denials , managed care, verifications/notifications, precertification. **Parallon**… more
- BrightSpring Health Services (Louisville, KY)
- …for all payor types striving to minimize lost revenue. Conducts analysis on denials and appeals and identifies trends that present process improvement and ... Our Company BrightSpring Health Services Overview Director of Clinical Denials Management and Audit supervises a team of RN/LPN...all areas of clinical claim pre and post audit, appeals submission, and reporting to Palmetto in response to… more
- Rush Copley Medical Center (Aurora, IL)
- **Position Summary** : The Appeals Specialist RN reviews inpatient hospital denials , clinical validation requests, and upheld denials after ... to details, and self-motivated. **Experience** + Knowledge/experience in utilization management, denials and/or appeals management in hospital or physician … more
- Texas Health Resources (Arlington, TX)
- …of Milliman or InterQual criteria required + Case management experience preferred + Denials and Appeals experience preferred + RN license to practice in ... and files appeal per contracted agreement. + Tracks, monitors, manage clinical denials and appeals and appeal outcomes for reporting as requested. + Serves as an… more
- HCA Healthcare (Nashville, TN)
- …technical denial arguments for reconsiderations. Identify contract protection to leveraged overturn denials . Argue appeals that prevent claim payment and gain ... join an organization that invests in you as an Appeals Specialist? At Parallon, you come first. HCA Healthcare...make a difference. We are looking for a dedicated Appeals Specialist like you to be a part of… more
- Guthrie (Binghamton, NY)
- …trending reports and reports reflecting recovery activity relative to requests, responses, appeals , denials and recoupments. The Coordinator will establish and ... Summary The Payor Audits and Appeals Coordinator will be responsible for monitoring timely...Coordinator will also be responsible for timely coordination of appeals and associated deadlines and reconciliation of payments and… more
- Randstad US (Woodland Hills, CA)
- …Grievance and Appeals Coordinators. Must be experienced with grievance and appeals , claim denials , medical terminology and CPT codes. Previous Grievance and ... grievance and appeals coordinator. + woodland hills , california +...copying, faxing and scanning incoming mail Skills + Claim Denials + CPT Codes Qualifications + Years of experience:… more
- Fallon Health (Worcester, MA)
- …and non-contracted providers with appeals regarding filing limit appeals , claim denials , claim payment, retrospective referrals, administrative inpatient ... **Brief Summary of purpose** : Responsible for the coordination and timely completion of provider appeals . Serves as a liaison between Fallon Health and contracted… more
- Beth Israel Lahey Health (Burlington, MA)
- …lives.** 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
- TEKsystems (Catonsville, MD)
- …+ 2 years of medical billing experience + Experience handling AR follow up/ denials + Experience handling appeals + EMR experience + Microsoft Office ... and/or charges. Essential Duties and Responsibilities: * Reviews and resolves payer denials , including appeals , coding corrections, medically necessity rules and… more
- Beth Israel Lahey Health (Burlington, MA)
- …lives.** Identifies, reviews, and interprets third party payments, adjustments and denials . Initiates corrected claims, appeals and analyzes unresolved third ... the Billing Supervisor with the resolution of complex claims issues, denials , appeals and credits. 18. Completes projects and research as assigned. **Secondary… more
- CareOregon (Portland, OR)
- …and NEMT subcontractors to gather supporting documentation to assist in managing grievances, denials or appeals to provide updates as needed. + Ensure all ... in health plan quality operations with emphasis if focused on grievances, denials and appeals content, or any work experience and/or training that would likely… more
- WMCHealth (Warwick, NY)
- …. + Supervises and coordinates the activities associated with billing, follow-up, and denials and appeals . + Works with staff, payer representatives, vendors, ... Supply Chain Automation is responsible for overseeing the billing, follow-up and denials management function at Bon Secours Charity Health System. This position is… more
