- Catholic Health Initiatives (Omaha, NE)
- …assigned facilities. The RN has an integral role within the revenue cycle by providing clinical expertise in the denials management process. The Denials RN ... findings to management. Recommends and provides education in collaboration with their manager . The Denials RN follows a standardized approach to managing… more
- St. Luke's University Health Network (Allentown, PA)
- …mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care ... regardless of a patient's ability to pay for health care . The Claim and Denial Coding Analyst role is...and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across… more
- Guidehouse (Birmingham, AL)
- …Companies to resolve claim denials and account balances. + Performing Non- Clinical Appeals + Assisting Supervisor/ Manager as needed with various projects. + ... Required** **:** None **What You Will Do** **:** The Central Denials Account Representative conducts thorough account reviews to determine the appropriate… more
- TEKsystems (Plano, TX)
- …on accounts. Including but, not limited to Managed Care , Reimbursement, Clinical , Admissions, Facility Business Office Manager , Coding, Case Management, HIM ... Required: + 2+ years of Insurance follow-up, denials /appeals experience (Medical A/R) + Hospital/facility collections experience Description: Responsible for A/R,… more
- Alameda Health System (San Leandro, CA)
- …made to discontinue the process; assumes the responsibility for coordinating and appealing clinical denials per department policy; develops any appeal letters to ... Care Management Clinical Appeals Specialist +...clinical guidelines; refers questionable cases to the CM Manager or physician advisor for determination. 3. Collaborates and… more
- WMCHealth (Warwick, NY)
- …formulates denials resolution strategies. + Works with the Follow-up Manager to establish and monitor accounts receivable management and cash collection ... Manager , System Patient Accounting Company: Good Samaritan Hospital...Automation is responsible for overseeing the billing, follow-up and denials management function at Bon Secours Charity Health System.… more
- LifePoint Health (Rutherfordton, NC)
- …services to communities. Duke LifePoint combines Duke's unparalleled expertise in clinical excellence and quality care with LifePoint's extensive resources ... gatekeeper of patients being admitted to the hospital by facilitating initiation of care starting.2. The ED Case Manager starts initiation and utilization… more
- Trinity Health (Livonia, MI)
- …and Local Health Physician Champions, Chief Medical Officers, HM Executive Leadership, clinical staff, coding and denials teams to facilitate documentation ... and co-morbidities are a complete reflection of the patient's clinical status and care . Resolves all discrepancies in a courteous manner. Demonstrates expertise… more
- AdventHealth (Glendale Heights, IL)
- …. The Social Work Care Manager ensures efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The ... Winthrop Ave, Glendale Heights, IL **The role you'll contribute:** The Social Work Care Manager intervenes with patients who have complex psychosocial needs,… more
- Huron Consulting Group (Chicago, IL)
- …to improve clinical outcomes and reduce the cost of providing patient care . Investing in new partnerships, clinical services and technology is not enough ... changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive… more
- AdventHealth (Orlando, FL)
- **Retail AdventHealth Primary Care Clinical Supervisor** **All the benefits and perks you need for you and your family:** . Commitment to whole-person care . ... Quality Assurance Program to monitor and control department services . Communicates to Clinical Manager all complaints and takes effective corrective action and… more
- UR Medicine Home Care (Rochester, NY)
- …reasonable accommodations: + Responsible for the review and correction of all assigned clinical documentation errors as identified in the agency EMR reports and work ... queues. + Collaborates with Clinical Operations (CHHA, Hospice, LHCSA)...requests by third party payers to respond to claim denials for medical justification including but not limited to… more
- Atlantic Health System (Morristown, NJ)
- …and critical thinking skills to assess patients for a clinically appropriate level of care and concurrent mitigation of denials . The UM RN maintains a strong ... knowledge base of evidence based clinical criteria, and federal, state UR requirements, and adeptly...and other intermediaries to secure payer authorizations and avoid denials or reduction in level of care .… more
- Hackensack Meridian Health (Hackensack, NJ)
- …but are not limited to Patient Accounting, Case Management, Health Information, Clinical , Training, Managed Care , Outsource Partners, Practice Management and DTS ... reports on high volume payment discrepancies which will be used as escalation to Managed Care , the payer, or DTS. Monitors payments denials and initiates CPT or… more
- Albany Medical Center (Albany, NY)
- …contract and works diligently toward the identification, mitigation, and prevention of clinical denials . In addition to contacting payers and providers via ... Payer database to ensure accuracy by Payer and Product line. + Reviews clinical denials including those related to pre-authorizations; work with Patient… more
- Crouse Hospital (Syracuse, NY)
- …utilization of resources, balanced with the patient's right to self-determination. The Manager of Care Coordination is responsible for providing day to ... Care Coordination is a collaborative practice model including...Areas of authority include Utilization Management, Discharge Planning and Denials and Appeals functions. General operational oversight including hiring… more
- Scottish Rite for Children (Dallas, TX)
- …to giving children back their childhood! Job Posting Title: Revenue Integrity Manager Location: Dallas - Hospital Additional Posting Details: Monday - Friday 8 ... will perform audits and reviews of departmental charge capture and reconciliation, denials management for all campuses, daily reporting and coordinated work on… more
- Geisinger (Danville, PA)
- Job Summary The Acute Care Manager for Geisinger at Home works with physician and multidisciplinary team members to develop plan of care for each assigned ... Ensure patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and evaluations. Assess and respond to patient and… more
- University of Michigan (Ann Arbor, MI)
- RN CASE MANAGER : University Hospital ( Care Management) Apply Now **Summary** The RN Case Manager assesses, develops, implements, coordinates and monitors a ... areas. The position is unique in that it combines clinical /quality considerations with regulatory/financial/utilization review demands. The position creates...RN Case Manager reports directly to the Manager of Care Management. The RN Case… more
- Covenant Health Inc. (Knoxville, TN)
- …and training for the coding staff. Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff ... serves as the user advocate between Health Information Management (HIM), Clinical Effectiveness, and Registration. Other job duties include: improving health record… more