- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-driven **UM RN Appeals Coordinator .** This role collaborates with clinical review staff, medical ... to ensure consistent clinical evaluation and processing of medical necessity appeals . Accurate documentation and detailed recordkeeping of notifications to members… more
- Nuvance Health (Danbury, CT)
- …Business Office related to appeals , denial and clinical reviews 9. Reviews new denials and appeal upheld cases in work queue and incoming fax queue. 10. Reviews ... Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician Advisors (PAs) and other stakeholders in ensuring… more
- Crossroads Hospice & Palliative Care (Green, OH)
- …ages and backgrounds + Problem-solving skills to research and resolve discrepancies, denials , appeals , collections Billing Coordinator Schedule & Benefits: ... we can create lasting impacts that transcend medical treatment. Billing Coordinator Responsibilities: + Obtain referrals and pre-authorizations as required for… more
- Catholic Health Services (Melville, NY)
- …Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization ... management and appeals functions to include coordination of specific process and...accurate utilization data in a timely fashion. + Monitors denials as well as all financial metrics associated with… more
- Community Health Systems (Franklin, TN)
- …denial and appeal status. + Consults with Coordinator and/or Director, Coding Denials and Appeals during any audit discrepancies. + Attends coding education ... of work products by the Coordinator and/or Director, Coding Denials and Appeals . + Partners with peers and Director to develop coder education based… more
- Community Health Systems (Franklin, TN)
- …to facilities regarding denials that are resulting in retractions. As an Appeals Specialist II at Community Health Systems (CHS) - SSC Nashville, you'll play a ... **Job Summary** The Appeals Specialist II - RN, under the direction...Responsible for review and resolution of pre pay insurance denials , correlating with the follow-up teams. + Works closely… more
- CommonSpirit Health (Englewood, CO)
- …are seeking a highly skilled individual to develop and submit clinical appeals , expertly crafting physician-aligned letters based on federal and state regulations, ... audit-ready case files with denial rationales and P2P documentation, ensuring successful appeals across all levels (1-5), including IRO and ALJ reviews, utilizing… more
- Insight Global (Nottingham, MD)
- …Requirements * High school diploma or equivalent * 3+ years' experience working in denials (following up on appeals , making adjustments, etc.) * Experience with ... to Day: Insight Global is looking for a Denial Coordinator to support a large hospital system in the...will be overseeing and managing the insurance denial and appeals process to minimize financial risk and improve reimbursement… more
- AdventHealth (Tampa, FL)
- …claim denials to perform the appropriate resolution, rebilling, and/or appeals steps. Assists with developing and implementing strategies and procedures to ... ro** **le you'll contribute:** The Ambulatory Payment Classification (APC) Coordinator is responsible for assigning, monitoring, and evaluating the...reduce denials , maximize reimbursements, and promote faster payment. Resolves claim… more
- HCA Healthcare (Manchester, NH)
- …care like family! Jump-start your career as a Medical Staff Services Coordinator today with Catholic Medical Center. **Benefits** Catholic Medical Center, offers a ... may vary by location._ Come join our team as a Medical Staff Services Coordinator . We care for our community! Just last year, HCA Healthcare and our colleagues… more
- Houston Methodist (Houston, TX)
- …| 8:00 AM - 5:00 PM At Houston Methodist, the International Finance Coordinator (IFC) position is responsible for performing the daily tasks of the Finance ... Department and provides prompt internal and external problem resolution. + Identifies denials trends and notifies department management to prevent future denials … more
- Robert Half Office Team (Cincinnati, OH)
- …compliance and efficiency in authorization processes. * Analyze trends in authorization denials and collaborate with teams to manage appeals , escalations, and ... Description We are looking for a dedicated Insurance Referral Coordinator to join our client's team in Cincinnati, Ohio. In this long-term contract role, you will… more
- Mount Sinai Health System (New York, NY)
- …in accordance with policies and procedures. + May run and work missing charges, edits, denials list and process appeals . Posts denials in IDX on a ... **Job Description** The Offsite Billing Coordinator is responsible for multiple components of the billing process, including Accounts Receivable, Charge Entry, Edits… more
- Children's Hospital Boston (Boston, MA)
- …insurance companies to obtain medication and equipment prior authorizations, and assists with denials and appeals when needed. + Coordinates and tracks prior ... 82462BRJob Posting Title:Prior Authorization Coordinator -Pharm TechnicianDepartment:NeurologyAutoReqId:82462BRStatus:Full-TimeStandard Hours per Week:40 Job Posting Category:ClinicalJob… more
- Highmark Health (Nashville, TN)
- …workflow within the department. + Prioritize requests for drug authorizations or denials . + Review of prior authorization criteria for drug products. + Recommend ... for guidance and assistance as necessary. + Document all authorizations and denials completely, accurately, and in accordance with timelines as defined by state… more
- Guthrie (Binghamton, NY)
- …for review and determination of coverage of ordered medications. + Coordinate and complete appeals for denials as needed + Monitor and Review REMS clearance for ... that qualify Monday through Friday 8:00am-4:30pm Position Summary: The LPN Care Coordinator will assist the providers with medication refills, patient messages, in… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient ... documented in patient's medical records. + Reviews notices of potential denials and respond appropriately; ie facilitate Physician to Physician appeals… more
- Guthrie (Corning, NY)
- …for review and determination of coverage of ordered medications. * *Coordinate and complete appeals for denials as needed * *Monitor and Review REMS clearance ... Position Summary: The LPN Care Coordinator will assist the providers with medication refills, patient messages, in basket monitoring, overdue results, referrals,… more
- Cardinal Health (Trenton, NJ)
- …identifies trend that inhibit timely payment + Work average of 50 to 100 denials per day based on supervisor requirements and accounts assigned + Works closely with ... recognizing their importance and relationship to patient care + Consults with appeals department for disputed / denied claims. + Works / Understands electronic… more
- Brockton Hospital (Brockton, MA)
- …external review agencies, to coordinate activities involved in medical record review, denials , appeals and reconsideration hearings. Works closely with the ... rounds. Proactively builds post hospital referrals and sends to the Transition Care Coordinator when indicated to facilitate timely discharge. Acts as a change agent… more
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