- Penn Medicine (Philadelphia, PA)
- …Coordinator is responsible for management of lists and processes related to denials and appeals . Coordinator also prepares quarterly denial reports by ... future each day. Are you living your life's work? **Summary:** + The Clinical Appeals Coordinator will play an essential role in maximizing collection of revenue… 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)
- … ensures efficient and effective management of utilization review processes, including denials and appeals activities. This role collaborates with payers, ... for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities, assists with process… more
- Houston Methodist (Houston, TX)
- …care benefits and post-acute care needs. + Streamlines concurrent insurance denials and/or appeals process, in collaboration with management and ... At Houston Methodist, the Case Management (CM) Coordinator position is a proficient CM representative that...to ensure effectiveness of post-acute care referrals or minimize denials or delays. + Participates in action plans for… more
- AdventHealth (Orlando, FL)
- …claim denials to perform the appropriate resolution, rebilling, and/or appeals steps._ + _Assists with developing and implementing strategies and procedures to ... **The role 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… more
- UNC Health Care (Hendersonville, NC)
- …Denial and RAC process, including requests, follow-ups, tracking of approvals and denials , and completing appeals . Oversees/maintains the denial and RAC ... of the unique communities we serve. Summary: The Recovery Audit Contractor (RAC) Coordinator (RN) is responsible and accountable for all Care Management Denial and… more
- Nuvance Health (Danbury, CT)
- …managers, Case Management Operation Coordinators, and Insurance companies. Sends provider appeals to insurance companies including Medicare and Medicaid for entire ... Reviews denial letters through daily mail. 3. Identifies retro denials and documents appropriately. 4. Notifies new retro ...Creates a weekly assignment for director to review for appeals . 6. Communicates with insurance companies to schedule a… 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
- Hackensack Meridian Health (North Bergen, NJ)
- …transform healthcare and serve as a leader of positive change. The **Care Coordinator , Utilization Management** is a member of the healthcare team and is responsible ... the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator , Utilization Management plans effectively in order to manage length of… more
- Corewell Health (Watervliet, MI)
- …for communication with appropriate health insurance companies regarding authorizations and denials . Executes standard work regarding Medicaid appeals / denials ... for obtaining necessary prior authorizations, submitting documentation to appeal denials , and educating clinicians regarding proper documentation for all Inpatient… more
- Mount Sinai Health System (Jackson Heights, NY)
- …processed in accordance with policies and procedures. 3. 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
- Sharp HealthCare (San Diego, CA)
- …benefits and accurately follows Health Plan and/or Medicare Guidelines when issuing denials .Ensures that all denials for medical necessity are issued under ... issued accurately and served timely to members or responsible party.Ensures that all denials for medical necessity are issued under the direction of the appropriate… more
- Squirrel Hill Health Center (Pittsburgh, PA)
- …is a Federally Qualified Health Center (FQHC), seeking a dedicated Clinical Support Coordinator to join our team. The ideal candidate will ensure that healthcare ... insurance companies to streamline the authorization process. The Clinical Support Coordinator will assist SHHC Providers in managing and maintaining electronic or… more
- Highmark Health (Dover, DE)
- …and contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials / appeals and retrospective payer audit denials . ... Collaboratively formulates plans of action for denial trends with the care coordination teams, performance improvement teams, physicians/physician advisor and third party payers. + Maintains a working knowledge of care management, care coordination changes,… 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
- Methodist Health System (Dallas, TX)
- …patient of surgery date and schedules 1 week post op appointment. * Handle all appeals and denials in conjunction with patient's care. * Participate in patient ... Of Week :** M-F **Work Shift :** **Job Description :** Your Job: Surgical Coordinator professional responsible to Serve as the patient point of contact with the… more
- Ochsner Health (New Orleans, LA)
- …for all phases of the transplant process (including insurance coverage and authorizations, denials and appeals ). + Plans, organizes, and prioritizes work to ... discuss with patients their insurance coverage in relation to the importance of their financial responsibility. Educates the patients on various available assistance options, as well as explain the financial impact of various alternatives. + Promptly and… more
- Sutter Health (San Francisco, CA)
- …or third-party payers as necessary to gather additional information and convey approvals, denials or appeals . + Provides excellent customer service by listening ... to provider, staff and patient concerns and assisting them in resolving issues in a courteous manner while documenting appropriately. + Cross-trains others to assure consistent coverage; provide back up support as needed. **EDUCATION:** HS Diploma or GED… more
- University of Rochester (Rochester, NY)
- …information and initiate corrected claim submission accordingly. - - Create and submit appeals for denials . - - Communicate with internal departments for ... authorization and coding issues. - - Document all actions and interact with ancillary areas to secure needed assistance. - - 10% - Review and complete activities related to various unbilled HAR's. - Monitor MUE Communication WQ's. 5% - Other duties as assigned… more
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