- 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 ... 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
- Hartford HealthCare (Farmington, CT)
- …. Conduct a thorough review of medical records, coding , and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit ... Related Group) validation denials . This role involves validating the coding and clinical accuracy, ensuring proper documentation, and collaborating with… 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...payers to successfully clear front end claim edits, appeal clinical denials , and address customer service inquiries.… more
- Fairview Health Services (St. Paul, MN)
- …DRG Validation, Clinical Validation, diagnosis codes not supported, and/or general coding error denials . + Responsible for reviewing assigned diagnostic and ... **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts...denial reports and other statistical reports. + Collaborates with Clinical Denials Nurse Specialist and Leadership in… 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 ... you will focus on the prevention and resolution of clinical claim denials by analyzing denial patterns,...with physician and hospital coders to ensure accurate CPT coding for emergency Medicare admissions and support correct hospitalization… more
- Kaleida Health (Buffalo, NY)
- **Director Clinical and DRG Denials ** **Location:** Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1 Job ... Description **Summary:** The Director, Clinical & DRG Denials provides ...managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG… more
- St. Luke's University Health Network (Allentown, PA)
- …and tracks outcomes regarding appeal process. Assists billing staff regarding outpatient denials for experimental, coding or other issues that may require ... clinically appropriate. + Investigates managed care and commercial insurance rejections, denials for possible experimental services and coding issues, providing… more
- Community Health Systems (Franklin, TN)
- …reason for the denial and appeal status. + Consults with Coordinator and/or Director, Coding Denials and Appeals during any audit discrepancies. + Attends ... periodic quality monitoring and evaluation of work products by the Coordinator and/or Director, Coding Denials and Appeals. + Partners with peers and Director to… more
- Independent Health (Buffalo, NY)
- …benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist-Senior will be responsible for reviewing ... coding and clinical decisions on cases involving complex clinical ...guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records,… more
- Albany Medical Center (Albany, NY)
- …working collaboratively to support all workflows related to professional fee coding /charging/ denials follow-up. Coordinates with others as needed to ensure ... Shift: Day (United States of America) Salary Range: $60,367.47 - $90,551.20 Professional Coding Auditor will apply an advanced professional coding skill set to… more
- Rush University Medical Center (Chicago, IL)
- …utilization. Provide feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding , and implement ... EMR charge capture support. 7. Serves as a liaison point of contact for clinical coding inquiries and communication for professional billing revenue cycle 8.… more
- Billings Clinic (Billings, MT)
- … coding . Analyzes and reports coding distribution and trends in clinical denials to providers and management. Analyzes payer bulletins and regulations and ... sessions on the full circle of proper revenue cycle practices regarding clinical documentation, coding , reimbursement, denials and appeals. Strives… more
- Atlantic Health System (Morristown, NJ)
- Responsible for coding quality audits of all records (outpatient, inpatient, procedures, testing) to assure appropriateness and accurate code assignments in ... for the providers and staff; also responsible for assisting with coding inquiries from providers, charge posters, billing staff, etc. Principal Accountabilities:… more
- Penn Medicine (East Petersburg, PA)
- …and resolve charges in work queues based on payer edits, CCI edits, and coding -related denials + Collaborate with customer service department to resolve ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- Catholic Health Initiatives (Chattanooga, TN)
- …action plans based on analysis. + Works collaboratively with Revenue Cycle Staff, Coding team, Clinical Informatics, and other MMS staff associated with HCC ... appropriate personnel for processing. + Acts as documentation and coding liaison to clinicians to include review ,..., education and necessary follow-up to help ensure that clinical documentation and coding services meet government… more
- Johns Hopkins University (Middle River, MD)
- …to include review of documentation. Serves as departmental expert on coding questions. Exercises independent judgment and decision making on a regular basis. ... III_** who will be responsible for all aspects of coding , quality assurance and compliance with Federal payer documentation...person. + Works with Department Management to create Charge Review Rules to prevent unnecessary denials . +… more
- University of Washington (Seattle, WA)
- …of the patient medical record from governance, integrity, documentation timeliness, completion, clinical coding , billing, release, and tracking to management of ... results of internal audits and partner with Compliance on external audit education + Review DRG and CPT claim denials for commercial payers and maintain written… more
- Carle Health (Urbana, IL)
- …all PRO/Insurance review correspondence related to medical record documentation and coding . + Reviews all DRG changes/ denials and prepares letters of ... dissemination of regulatory or compliance guidelines and changes related to coding . + Ensures proper coordination between Concurrent Clinical Documentation… more
- Hartford HealthCare (Farmington, CT)
- …1. Analyze and resolve specific billing edits and denials that require coding and billing expertise with some clinical knowledge that are delaying claims ... modifiers, diagnosis codes as appropriate including charge corrections 2. Identify charging, coding , or clinical documentation issues and work with appropriate… more
- HCA Healthcare (Salem, VA)
- …and personal growth, we encourage you to apply for our Medical Necessity Coding Compliance Coordinator opening. We promptly review all applications. Highly ... you have the career opportunities as a Medical Necessity Coding Compliance Coordinator you want with your current employer?...you will do in this role:** + Coordinate NCD/LCD/LCA review process at the Division level + Determine whether… more