- BronxCare Health System (Bronx, NY)
- …best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials ... Overview The Appeals Manager is responsible to assist...to assist the department attain its objective of managing denials and appeals . Responsibilities - Types, utilizing… 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
- 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
- Texas Health Resources (Arlington, TX)
- …Arlington, TX + Core work hours: Monday-Friday 8:00a-5:00p **Summary** The Billing, Coding & Denials Manager will oversee all aspects of claim review and coding ... ** Manager Billing Coding and Denials ** _Are...to issues identified with root cause analysis of the denials and appeals process Manage/Troubleshooting for high… more
- Colorado State University (Fort Collins, CO)
- Posting Detail Information Working TitleInsurance Denials Specialist Position LocationFort Collins, CO Work LocationPosition qualifies for hybrid/in-office work ... and a thriving arts and entertainment industry. Position Summary The Insurance Denials Specialist will provide excellent customer service and guidance to all CSU… more
- CenterWell (Honolulu, HI)
- …responding to, managing and monitoring all payer requests for additional documentation (ADR), appeals and denials . Works with branch staff to gather required ... to develop appropriate and timely responses. + Responsible for constructing response to denials and appeals , utilizing any federal guidelines or local coverage… more
- St. Luke's University Health Network (Allentown, PA)
- …to, physicians, hospital employees and vendors. Advises Network CDI & DRG Denials Manager on issues requiring immediate attention. ADDITIONAL REQUIREMENTS: ... regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of… more
- Elevance Health (Irving, TX)
- …additional information if necessary. + Ability to initiate pre-determination, prior authorizations, and appeals for denials based on payer policy. + Ability to ... home setting._ **Referral Specialist II/Patient Access (Pre & Prior Authorizations, Appeals , Insurance) - Paragon Infusion** **Location:** 3033 W President George… more
- Johns Hopkins University (Middle River, MD)
- …issues and facilitate prompt payment of claims. Communicates with providers regarding appeals and medical policy denials and provides appropriate proactive ... related to specialized, complex or high-cost procedures. + Contacts providers regarding appeals and medical policy denials , identifies and collects additional… more
- NTT America, Inc. (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
- Children's Mercy Kansas City (Kansas City, MO)
- …manages high risk administrative processes and data related to medical necessity denials , clinical appeals , long length of stay rounds, and ... tools and tracking to monitor status and outcomes of denials and appeals to identify trends and...expert at the roles of Clinical Review Nurse Care Manager and Care Coordination Case Manager and… 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
- Covenant Health Inc. (Knoxville, TN)
- …guidelines. + Provides education to auditors, nurse and coders in department relative to denials and appeals processes based on final review of denial. Escalates ... level professional internal analysis related to root cause and resolution of denials for corrective action. Work involves research and analysis of revenue cycle… more
- UNC Health Care (Chapel Hill, NC)
- …to coder questions and provide training and education. This position processes and appeals insurance coding denials . This position analyzes coded records for ... and ancillary cases). 3. Faxes, tracks, and monitors coding denials and appeals on both inpatient and...software (eg Optum, Epic, PWC SMART, MS Office, Audit Manager etc.) to compile and validate medical information. **Other… more
- Hunterdon Health Care System (Flemington, NJ)
- …are accounted for within the master charge master file. + Tracks AR days, denials , appeals , and recommends policy and procedure changes to reduce and prevent ... for all hospital ancillary areas. Maintains best practices with registration, billing, denials , payment posting and collection follow up processes using HFMA data.… 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
- Robert Half Finance & Accounting (Asheville, NC)
- Description We are looking for a skilled Billing Supervisor/ Manager to oversee medical billing processes and ensure the accuracy and efficiency of claims management ... a dedicated and detail-oriented individual with expertise in medical billing, appeals handling, and insurance claims management. The ideal candidate will bring… 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
- Mount Sinai Health System (New York, NY)
- …Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status of Medical Record requests ... ability to perform clinical/technical/service/administrative tasks: + Prioritizes Insurance Requests / Denials when received in the department as per protocol +… more
- UnityPoint Health (Cedar Rapids, IA)
- …training and maintaining competencies for office staff, and working insurance denials . Adheres to detail in the performance of rehabilitation procedures, solving ... for therapy, prompt pay, and financial assistance applications. Accurate billing/collections/ denials : + Reconciles daily patient attendance and charges posted with… more