- UHS (Wayne, PA)
- …must be within commuting distance to the King of Prussia, PA headquarters. Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as ... communities we serve. To learn more about IPM visit Physician Services - Independence Physician Management...Management - UHS. Position Overview The Accounts Receivable Specialist is responsible for the accurate and timely follow-up… more
- Regal Medical Group, Inc. (Northridge, CA)
- …or in making recommendations for other determinations to the provider/vendor ( denial /modification/redirection). The goal of the medical director will cooperate with ... to deliver excellent care in a cost-effective manner based on medical management referral processing guidelines. The medical director will be detail-oriented and… more
- Baptist Memorial (Memphis, TN)
- …as obtaining authorizations, claims review, patient billing, appeal writing, auditing, and/or denial management ; 3-5 years case management experience, or ... Overview Specialist - Denial Mitigation II RN Job Code:...nursing program Training Description Minimum Required Preferred/Desired Nursing, Case Management or Denial Management . Familiarity… more
- Hartford HealthCare (Farmington, CT)
- …now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the ... system.*__* *_Position Summary:_* The Audit Specialist is responsible for reviewing clinical documentation to determine appropriate coding assignment for ICD-10,… more
- St. Luke's University Health Network (Allentown, PA)
- …billing for physician and advanced practitioner services for the St. Luke's Physician Group. The Accounts Receivable Specialist I is responsible for accurate ... ability to pay for health care. The Accounts Receivable Specialist I is responsible for the billing and collection...Identifies and reports any claim submission issue trends to Management team. + Obtains and maintains a basic understanding… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records ... not limited to utilization review, hospital reimbursement, clinical compliance, case management , and transitions of care, as outlined in the responsibilities below.… more
- HCA Healthcare (Nashville, TN)
- …resolving coding related denials from payers, preventing lost reimbursement and promoting denial prevention. The Inpatient Coding Denials Specialist will adhere ... billing, revenue integrity, collections, payment compliance, credentialing, health information management , customer service, payroll and physician billing. We… more
- Houston Methodist (Houston, TX)
- …is responsible for coordinating and monitoring the coding-specific clinical charges and denial management and appeals process in a collaborative environment with ... feasibility of submitting appeals. + Works with revenue cycle management and staff to ensure claim edit/ denial ...of the following: + * CCS - Certified Coding Specialist (AHIMA) + * CPC - Certified Professional Coder… more
- PeaceHealth (Vancouver, WA)
- …AK or TX to be eligible for consideration. **Job Summary** Coding Denials Specialist analyzes, processes, and resolves claim denial requests. Provides support to ... **Description** PeaceHealth is seeking a Coding Denials Specialist . This position is remote but does require...CDI and Hospital Coding when questions arise regarding claim denial requests. + Processes letters from physician … more
- Weill Cornell Medical College (New York, NY)
- …critical thinking and analytical skills. + Ability to meet daily coding and denial management production requirements along with quality as per Company norms. ... Title: Revenue Cycle Specialist -Revenue Integrity (Remote) Location: Midtown Org Unit: AR...retrospective coding and documentation review of denied charges for physician services. Reviews medical records for completeness and accuracy… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically… more
- Prime Therapeutics (Salem, OR)
- …and drives every decision we make. **Job Posting Title** Medication Therapy Management (MTM) Specialist - Remote **Job Description** Evaluates and authorizes ... + Determines appropriateness for medications. Communicates decision to physicians, physician `s office staff, medical management staff and/or pharmacists.… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is ... identified by the Revenue Cycle Managers. In addition, the Revenue Cycle Specialist is responsible for resolving all outstanding third-party primary and secondary… more
- Dana-Farber Cancer Institute (Brookline, MA)
- Working in a fast-paced, high volume, dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals ... plans. Reporting to the Prior Authorization Supervisor , the Clinical Authorization Specialist is responsible for managing all work related to molecular pathology,… more
- St. Luke's University Health Network (Allentown, PA)
- …strategies for clinical documentation or current program in use for clinical documentation management program. Work with the physician advisor in review of ... of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis… more
- University of Washington (Seattle, WA)
- …As a member of the health care team, the Program Operations Specialist performs program development administration and management for specific programs ... with billing and institutional policies and procedures, and providing project management for implementation Works with physician and department leadership… more
- Seattle Children's (Seattle, WA)
- …creation of educational materials. Experience in revenue cycle functions, including coding denial management and appeals process. Experience in research of payer ... to ensure coding and documentation compliance. **Required Credentials** Certified Coding Specialist - Physician Based (CCS-P) certification by the American Health… more
- Henry Ford Health System (Troy, MI)
- …successful authorization procurement is obtained from back end coding, billing and denial management resources and distributed to ordering physicians and ... The purpose of the Central Authorization Specialist position is to centrally facilitate the successful procuring of insurance authorizations for ordered procedures… more
- HCA Healthcare (Nashville, TN)
- …billing, revenue integrity, collections, payment compliance, credentialing, health information management , customer service, payroll and physician billing. We ... individual is recognized. Submit your application for the opportunity below:Appeals Specialist . **Benefits** Parallon, offers a total rewards package that supports… more
- Tufts Medicine (Burlington, MA)
- …this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality ... of deficiencies, within Epic, for missing documentation. Works with leadership to review denial reports as well as participating in internal and external audits to… more
