- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of ... In this role, you will be responsible for evaluating and responding to clinical and administrative denials referred to Case Management Department for appeal. You… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor directs and coordinates the accurate implementation of the clinical appeal process ... Directs the activities and serves as a resource for associates within the Clinical Appeals and Analysis unit. We are looking for an experienced clinical … more
- Catholic Health (Buffalo, NY)
- …role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for the people, carrying out and ... documenting the appeals process for denied claims denied due to reasons...denied due to reasons including, but not limited to clinical documentation/support for diagnostic related grouping (DRG) assignment, inpatient… more
- Guidehouse (Birmingham, AL)
- …to Insurance Companies to resolve claim denials and account balances. + Performing Non- Clinical Appeals . + Assisting Supervisor /Manager as needed with ... various projects. + Escalate payer issues/trends to a supervisor with the appropriate information or take appropriate action...+ 0-2 years medical billing experience working with UB04, appeals & denials. **What Would Be Nice to Have**… more
- Catholic Health Services (Melville, NY)
- …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...all insurance and regulatory audits and provides information to supervisor related to inaccurate and/or missing documentation as applicable.… more
- Covenant Health Inc. (Knoxville, TN)
- …appeals hand-offs, maintaining payer correspondence and claims processing. + Notifies Appeals Supervisor or Revenue Integrity Manager when trends are ... the denials management system and performing timely follow-up with regard to clinical and medical necessity insurance appeals . Analyzes all correspondence… more
- State of Colorado (CO)
- …V- Forensic Community Based Services Supervisor Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5122128) Apply Health Professional ... V- Forensic Community Based Services Supervisor Salary $78,684.00 - $110,160.00 Annually Location Statewide, CO Job Type Full Time Job Number IIB-03507 10/24/25… more
- Integra Partners (Troy, MI)
- …criteria (eg, InterQual, CMS, health plan policies). + Review and process clinical and administrative appeals ; coordinate with Medical Director when required. ... The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and...team performance, escalating issues as needed to the UM Clinical Manager. + Ensure compliance with all regulatory, contractual,… more
- HCA Healthcare (Miramar, FL)
- …**Introduction** Are you ready to manage in a new era as a CBO Collections Supervisor where building a healthier tomorrow is more than a job? Our Surgery Ventures ... Be an impact as a Central Billing Office Collections Supervisor where your passion for leading and creativity are...follow-up on insurance denials for all collectors to assure appeals are completed within 24-48 hours from the receipt… more
- State of Colorado (Denver, CO)
- …student supervisor , the Social Worker III is responsible for clinical and administrative supervision, as well as performance management and disciplinary ... Social Work III - Clinical Services Fort Logan Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5057452) Apply Social Work III - Clinical … more
- Dana-Farber Cancer Institute (Brookline, MA)
- …high volume, dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and ... and various health plans. Reporting to the Prior Authorization Supervisor , the Clinical Authorization Specialist is...+ Root causes claim denials, reprocesses, and submits claim appeals . + Creates drug cost estimates for both on-label… more
- Ventura County (Ventura, CA)
- Certified Coding Supervisor - Health Information Management Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4892159) Apply Certified Coding ... Supervisor - Health Information Management Salary $94,952.15 - $132,946.07...Information Management (HIM) department related to coding and CDI ( clinical documentation improvement). The ideal candidate will have a… more
- State of Colorado (Pueblo, CO)
- Social Worker/Counselor III - Clinical Work Lead Continuity of Treatment Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5097088) Apply Social ... Worker/Counselor III - Clinical Work Lead Continuity of Treatment Salary $82,620.00 -...years of facilitating psychotherapy/psychoeducation groups + Experience as a supervisor or work lead + Previous state experience Conditions… more
- Select Medical (Dallas, TX)
- …venture with Select Medical & Baylor Scott & White Health Dallas, TX ** Clinical Intake Coordinator / Clinical Liaison (RN strongly preferred)** **Full-Time, ... Monday through Friday 8am - 5pm** **Competitive base salary with monthly bonuses!** Clinical Liaisons are advocates who educate and guide patients toward the next… more
- Robert Half Accountemps (Vista, CA)
- …healthcare organization in Vista is seeking an experienced Medical Billing Supervisor to oversee the billing department and ensure timely, accurate claims ... + Ensure timely follow-up on outstanding claims and coordinate corrections or appeals . + Maintain compliance with HIPAA, Medicare, Medi-Cal, and all other payer… more
- Centene Corporation (Jefferson City, MO)
- …fresh perspective on workplace flexibility. **Position Purpose:** Responsible for leading clinical coding compliance nurses and non- clinical team members through ... + Identifies and implements best practices and operational efficiencies + Researches clinical and coding questions and issues + Triages and resolves escalated health… more
- AdventHealth (Orlando, FL)
- …be part of a team . Knowledge of medical terminology and understanding of clinical concepts . Ability to speak confidently with physicians and leadership . Ability ... quickly . Knowledge of insurance practices regarding benefits, authorizations and appeals **EDUCATION AND EXPERIENCE REQUIRED:** . Four (4) years of experience… more
- University of Washington (Seattle, WA)
- …and experiential offerings. The University of Washington School of Law's Clinical Program provides students with real-world legal experience assisting clients and ... for academic credit supervised by experienced faculty members. The Clinical law program currently has 10 in-house clinics (https://www.law.uw.edu/academics/experiential-learning/clinics)… more
- Mount Sinai Health System (New York, NY)
- …Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical /Technical/Service** + Demonstrates the ability to perform clinical ... + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements...of the hospital staff and extended community. + Notifies Supervisor of obstacles / problems affecting the completion of… more
- Houston Methodist (Houston, TX)
- …required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the professional fee environment. This ... other team members as advised by the Manager and/or Supervisor . + Identifies denial trends and notifies Supervisor...complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits appeals when… more
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