- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Coding Appeals Specialist analyzes patient medical records, claims data and ... MS-DRG for the purposes of appealing proposed MS-DRG and coding changes by insurance providers or their auditors. Assures...provide feedback, including identification of trends, to the Network Coding and CDMP Managers for education of the medical… more
- Healthfirst (FL)
- …as: certain types of claim denials, member complaints, and member and provider appeals . The end-to-end process requires the Specialist to independently: + ... Work within a framework that measures productivity and quality for each Specialist against expectations + Work independently exercising judgment starting the case… more
- Hartford HealthCare (Farmington, CT)
- …Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS),and/or Certified Clinical Documentation ... . Prepare, document, and submit appeals for DRG denials, ensuring appeals are well-supported with clinical evidence, coding guidelines, and regulatory… more
- Houston Methodist (Houston, TX)
- …& Denials Specialist is responsible for coordinating and monitoring the coding -specific clinical charges and denial management and appeals process in a ... and functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS**...Certified Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved… more
- Molina Healthcare (Omaha, NE)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals… more
- Independent Health (Buffalo, NY)
- …a culture that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding ... They will aid in training other team members, evaluating appeals , and share audit trends across the team. Expertise...and audit tips across the team. The Clinical & Coding Specialist -Senior will support the leadership in… more
- Fairview Health Services (St. Paul, MN)
- …or Registered Health Info Tech (RHIT) or Certified Inpatient Coder (CIC) or Certified Coding Specialist (CCS) **Preferred Qualifications** + BS/BA in HIM + 7+ ... **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts...medical records and coding guidelines to formulate coding arguments for appeals and/or coding… 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 ... 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 $300… more
- Beth Israel Lahey Health (Burlington, MA)
- …CPC-A (Certified Professional Coder - Apprentice through AAPC), or CCS-P (Certified Coding Specialist Physician Based through AHIMA) Experience: 1-2 years of ... services. Reviews provider documentation in order to determine appropriate coding and initiate corrected claims and appeals ....appropriate coding and initiate corrected claims and appeals . Duties include hands on coding , documentation… more
- HCA Healthcare (Brentwood, TN)
- …colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Denials Coding Review Specialist with Parallon you can be a part of an ... to succeed in our organization. We are looking for an enthusiastic Clinical Denials Coding Review Specialist to help us reach our goals. Unlock your potential!… more
- Trinity Health (Fort Lauderdale, FL)
- …Integrity staff and providers to educate on improved documentation to support coding . Neurosurgery experience is highly preferred. CPC license is REQUIRED. **What ... you will do:** Responsible for coding and/or validation of charges for more complex service...(PBS) centers, including analysis of clinical documentation, assisting in appeals , root cause analysis and tracking as needed. 6.… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …+ Education + High school graduate is required. Completion of medical terminology and coding classes in ICD-9-CM. + Experience + Requires minimum of two years in ... ICD-9-CM coding experience. Previous healthcare billing and follow-up experience preferred....Calling insurances to follow up on payment status or appeals due to denials or incorrect payments. Calling patients… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Coding Specialist , Centralized Coding Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's ... Business Office personnel to resolve issues related to claims, coding , pre-cert, and denials appeals , and verifies...related to claims, coding , pre-cert, and denials appeals , and verifies that appropriate chargemaster rates are used.… more
- Billings Clinic (Billings, MT)
- …Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or other recognized AAPC or AHIMA ... the full circle of proper revenue cycle practices regarding clinical documentation, coding , reimbursement, denials and appeals . Strives to maximize reimbursement… more
- Ventura County (Ventura, CA)
- …a Bachelor's Degree in Health Information Management, strong Inpatient and Outpatient coding experience and Certified Coding Specialist certification ... and HCAI requirements; + Reviews insurance denials and submit appeals as necessary, provide education to coders based on...skill with Excel + Must have a current Certified Coding Specialist (CCS) certification + Possession and… more
- St. Luke's University Health Network (Allentown, PA)
- …after review of supporting documentation, CCI/LCD, carrier policy and utilization of coding software applications. The appeals process may include collaboration ... to pay for health care. The Claim and Denial Coding Analyst role is a Certified Medical Coder who...with the Claim Editing Manager, Physician, Specialty Coder, AR specialist or Auditor/Educator. Demonstrate the ability to formulate an… more
- Johns Hopkins University (Middle River, MD)
- …edits reports, file or pull EOB batches. + Identifies and escalates non-standard appeals to a higher-level specialist . + Informs the supervisor / Production ... for the basic collection of unpaid third-party claims and standard appeals , using various JHM applications and JHU/ PBS billing applications. Communicates… more
- Houston Methodist (Houston, TX)
- …in resolution. Engages the coding follow up team for any medical necessity or coding related appeals . + Assures accounts are completed and worked at a high ... At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect...perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the professional fee… more
- Johns Hopkins University (Middle River, MD)
- …edits reports, file or pull EOB batches. + Identifies and escalates non-standard appeals to a higher-level specialist . + Informs the supervisor / Production ... for the basic collection of unpaid third-party claims and standard appeals , using various JHM applications and JHU/ PBS billing applications. Communicates… more
- Globus Medical, Inc. (Collegeville, PA)
- …Summary** **:** Reporting to the Supervisor, Patient Access, the Patient Access Specialist will focus on providing payer coverage support to customers from the ... initial processing of received documentation through prior authorization, appeals support, detailed claims review, and hotline support. The Patient Access … more