- Nuvance Health (Danbury, CT)
- …departments, team members, providers, delegates, and community partners. In addition, the Manager Denials Prevention & Appeals Operations is responsible ... and provide coaching and feedback to team members. * Collaborate with Manager Denials Prevention & Appeals Administration to oversee UR processes for… more
- Garnet Health (Middletown, NY)
- …is responsible for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate ... overall quality, completeness, and accuracy of medical record documentation. The Manager will evaluate denials and work closely with the outcomes manager and… more
- Catholic Health (Buffalo, NY)
- …hours based on role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for the people, carrying ... a liaison between front-end clinical areas and third-party payers in scenarios related to denials and appeals . This position educates all members of the patient… more
- Hartford HealthCare (Farmington, CT)
- …review of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials , ... multiple denials , prioritize tasks, and ensure timely submission of appeals . . Experience with electronic health record (EHR) systems, coding software, and… more
- Banner Health (AL)
- …to make Banner Health the best place to work and receive care. As an Associate Manager of RN Denials Management, you will be an integral part of leadership ... rounding on team members to ensure quality reviews of payer denials and/or appeals . Accurately and thoroughly completes documentation required for claims payment… more
- Beth Israel Lahey Health (Plymouth, MA)
- …making a difference in people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth ... Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs...Reviews and determines appropriate strategy in response to reimbursement denials . + Responsible for appeals and follow… more
- Robert Half Accountemps (Fort Worth, TX)
- Description We're seeking an experienced Infusion Billing and Denials Specialist to join a growing healthcare organization. This role will play a key part in ... stabilizing and improving the infusion billing process, managing claim denials , and supporting the transition to an in-house billing model. The ideal candidate… more
- Guidehouse (Birmingham, AL)
- …to resolve claim denials and account balances. + Performing Non-Clinical Appeals . + Assisting Supervisor/ Manager as needed with various projects. + Escalate ... expert can effectively resolve the matter. + Communicate to Supervisor/ Manager areas of concern or areas of improvement. +...+ 0-2 years medical billing experience working with UB04, appeals & denials . **What Would Be Nice… more
- Mohawk Valley Health System (New Hartford, NY)
- Supervisor, Denials Mgmt & Efficiency - Hybrid Flexible Department: ACCTS RECEIVABLE & COLLECTION Job Summary The Supervisor of Denials Management and Efficiency ... operational excellence within the Billing Office by improving workflows, reducing denials , and fostering collaboration across MVHS. This position leads a focused… more
- BronxCare Health System (Bronx, NY)
- Overview Assists in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute ... action in order to improve outcomes. - Maintains an excel log related to denials / appeals activities in order to monitor successful appeals . - Assists with… more
- Penn Medicine (East Petersburg, PA)
- …are met in an appropriate manner. Responsibilities: + Analyzes and researches denials and follows-up with the appropriate payor, practice, and/or patient to resolve ... to expedite the resolution of the denied claim. + Performs all appeals and denial recovery procedures needed to appropriately and accurately resolve denied… more
- Beth Israel Lahey Health (Charlestown, MA)
- …difference in people's lives.** This is a remote based role. Reporting to the Manager , Patient Financial Services, the Clinical Analyst plays an important role in a ... high-profile team tasked with handling all commercial and government clinical appeals and audit processes. The Clinical Analyst will perform high-level clinical… more
- Catholic Health Services (Melville, NY)
- …services and coordinates utilization/ appeals management review. + Assist Utilization and Appeals Manager in setting up communications with payors and/ or ... accurate utilization data in a timely fashion. + Monitors denials as well as all financial metrics associated with...departments. + Develops/validates daily work lists for Utilization and Appeals Manager . + Assist with all insurance… more
- Stanford Health Care (Palo Alto, CA)
- …Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials . This position requires ... and opportunities for improvement. + Maintains accurate records of appeals and denials for tracking and reporting...with Management: Identify and escalate denial patterns to the Manager of Government Audits and Appeals , providing… more
- Guthrie (Sayre, PA)
- …Audit Manager is responsible for the oversight and management of all payer denials , appeals , and audit processes within the health system. This role ensures ... or insurance with responsibility and management of billing and reimbursement. Essential Functions Denials & Appeals Management + Oversee daily operations of the … more
- Houston Methodist (Katy, TX)
- …to: medical coding, insurance billing, collections, patient account resolution, appeals / denials , customer service, cash applications, revenue integrity, etc. ... At Houston Methodist, the Manager Revenue Cycle position is responsible for the...limited to the following: accounts receivable days, cash collections, denials , avoidable write-offs, staff productivity and work quality and… more
- NTT DATA North America (Plano, TX)
- …and forward-thinking organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is seeking to hire a **Medicare ... Appeals Clinical Leader** to lead service delivery engagements and...interpret medical records, documenting recommendations to uphold or overturn denials + Excellent analytical and problem-solving skills + Strong… more
- Houston Methodist (Houston, TX)
- …services. This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in ... Supervisor. + Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further...queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits… more
- HCA Healthcare (Nashville, TN)
- …requests for intervention from the centralized peer-to-peer team and others regarding denials and appeals processes, observation level of care, decisions about ... have the career opportunities as a Quality Control Senior Manager you want with your current employer? We have...and address payer medical policies that lead to inappropriate denials , advocating for fair and accurate coverage. + Provide… more
- Covenant Health Inc. (Knoxville, TN)
- …Business Office personnel to resolve issues related to claims, coding, pre-cert, and denials appeals , and verifies that appropriate chargemaster rates are used. ... and hospital personnel to ensure qualifying diagnosis covers tests/procedures. + Analyzes denials and coordinates appeals . + Ensures corrective action is taken… more