- CommonSpirit Health Mountain Region (Centennial, CO)
- …with resources to help you flourish and leaders who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management ... third-party payers to appeal denied claims and retrospectively identifies appeals determination as indicated through research and coordination of...must be in CO, UT, or Kansas.** Must have Clinical Denials experience. Please make sure it's… more
- Hartford HealthCare (Farmington, CT)
- …of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials , ... **Job:** **Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 2 / HIM Coding* **Location:**… more
- Houston Methodist (Sugar Land, TX)
- …and billing processes, managed care contracts and coordination of benefits related to coverage, clinical appeals , and denials to include knowledge of CPT and ... and denials for no authorization. The Senior Denials Management Specialist position communicates clinical...cycle clinical role + Experience includes writing clinical appeals for medical necessity compliance or… more
- HCA Healthcare (Brentwood, TN)
- …HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Denials Coding Review Specialist with Parallon you can ... resources you need to succeed in our organization. We are looking for an enthusiastic Clinical Denials Coding Review Specialist to help us reach our goals.… more
- UHS (Binghamton, NY)
- Position OverviewUnited Health Services (UHS) is seeking a proactive and analytical Clinical Denials Specialist to join our Revenue Cycle team. In this vital ... role, you will focus on the prevention and resolution of clinical claim denials by analyzing denial patterns, investigating and appealing denied claims, and… more
- Houston Methodist (Houston, TX)
- …staff; and functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** + Communicates openly in a ... At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating... is responsible for coordinating and monitoring the coding-specific clinical charges and denial management and appeals … more
- Dana-Farber Cancer Institute (Brookline, MA)
- Under the general supervision of the Director of Patient Financial Services, the Clinical Appeals Specialist performs advanced level work related to ... denials by conducting a comprehensive review of relevant clinical documentation. The Clinical Appeals Specialist will write compelling arguments… more
- Fairview Health Services (St. Paul, MN)
- …the development of denial reports and other statistical reports. + Collaborates with Clinical Denials Nurse Specialist and Leadership in high-dollar claim ... **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts to...appeals or re-billing of claims to resolve coding denials to ensure collection of expected payment and mitigation… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... and rejections. + Assists in preparing reports regarding denials to include volumes, number of appeals ,...preferred. TRAINING AND EXPERIENCE: Minimum of 2-5 years of clinical nursing experience in an acute care hospital setting… more
- HCA Healthcare (El Paso, TX)
- …and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts ... you want to join an organization that invests in you as an Inpatient Coding Denials Specialist ? At Parallon, you come first. HCA Healthcare has committed up to… more
- Healthfirst (FL)
- …and resolution of non- clinical cases, such as: certain types of claim denials , member complaints, and member and provider appeals . The end-to-end process ... Work within a framework that measures productivity and quality for each Specialist against expectations + Work independently exercising judgment starting the case… more
- Community Health Systems (Franklin, TN)
- …the denial and appeal status. + Consults with Coordinator and/or Director, Coding Denials and Appeals during any audit discrepancies. + Attends coding education ... quality monitoring and evaluation of work products by the Coordinator and/or Director, Coding Denials and Appeals . + Partners with peers and Director to develop… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve ... and off-label drug authorizations. The Clinical Authorization Specialist is also responsible for managing denials ...Creates cost estimates for waivers. + Root causes claim denials , reprocesses, and submits claim appeals . +… more
- Independent Health (Buffalo, NY)
- …coding guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records, consultation with ... and a culture that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding… more
- Houston Methodist (Houston, TX)
- …This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the ... At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect...queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... management policies. This role conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers… more
- Mount Sinai Health System (New York, NY)
- … Clinical /Technical/Service** + Demonstrates the ability to perform clinical /technical/service/administrative tasks: + Prioritizes Insurance Requests / Denials ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days...Appeals Nurse / Manager by confirming status of denials + Tracking status of Medical Record requests for… more
- Omaha Children's Hospital (Omaha, NE)
- …prior authorizations, and managing denials by collaborating with clinical , administrative, and financial teams. The Authorization Specialist supports ... with organizational standards. + Denial Management + Identify and resolve authorization-related denials by working closely with clinical teams, payers, and… more
- Robert Half Accountemps (Duarte, CA)
- …denied claims by identifying root causes and implementing corrective measures to reduce future denials . * Draft and submit appeals for claim denials to ... Description We are looking for an experienced Medical Biller/Collections Specialist to join our team in Duarte, California. The...in handling Medicare, Medi-Cal, and other insurance claims, including denials and appeals . * Strong knowledge of… more
- Movn Health (CA)
- …to all payers within 24 hours of service + Review and process claim denials and rejections, executing timely appeals and follow-up strategies + Aggressively ... seeking a highly experienced Senior Medical Biller & A/R Specialist to take full ownership of claims processing and...with a proven track record in A/R recovery, claim appeals , and payer follow-ups. Experience in startup environments and… more
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