- Stanford Health Care (Palo Alto, CA)
- …and Appeal Specialist II plays a critical role in the Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government ... audits and denials . This position requires strong clinical acumen, a strong...There are three (3) career banded levels within the Denials Management family. Positions are flexibly staffed at any… more
- Geisinger (Scranton, PA)
- …through appropriate administrative and medical channels to avoid third party payer denials . Maintains awareness of all concurrent denials through interaction ... with payer liaison. Works with payer liaison to facilitate timely discharge or alternative plan of care acceptable to physician, family and payer. Works with physician and multidisciplinary team members to develop plan of care for each assigned patient from… more
- US Physical Therapy (Decatur, GA)
- …billing and claims department with collections of patient balances, managing denials and assisting the Office Manager with outstanding A/R. **Responsibilities:** + ... prior authorizations + Follow up with insurance companies on unpaid claims and denials . + Assist with Answer phones and scheduling new patients + Provide excellent… more
- Mom's Meals (Ankeny, IA)
- …tools in CRM and SharePoint + Manage complex billing scenarios including denials , rejections, and aging accounts + Collaborate with Posting teams to resolve ... portals, etc.) + Resolve claim rejections timely and resolve claim denials through research, appeals, claim corrections/resubmission, and follow-up with health plans… more
- Stony Brook University (Stony Brook, NY)
- …on all other payers. + Active participation with the physician and payer to prevent denials . Reviews cases for potential change in level of care with the CM and ... + Reviews cases daily from admission through discharge to prevent denials .This includes patient and family contacts, insurance authorizations, tests, procedures,… more
- Mom's Meals (Ankeny, IA)
- …portals, etc.) + Resolve claim rejections timely and resolve claim denials through research, appeals, claim corrections/resubmission, and follow-up with health plans ... in process improvement initiatives. Collaborate across teams to resolve issues, claims denials , and aging + Other tasks as assigned, including but not limited… more
- Stony Brook University (East Setauket, NY)
- …but are not limited to:** + Prepare and submit hospital claims. Review denials . Investigate coding issue. Audits. + Follow-up on rejected or denied claims, improper ... claims/insurance companies and review to increase revenue and prevent unnecessary denials . + Assist the supervisor in scheduling, timesheet, leave requests,… more
- Earth Saving Solutions (Denver, CO)
- …liaise directly with adjusters, and advocate on behalf of clients to overturn denials and secure full reimbursements. * Solution Design : Partner with ESS's ... success in negotiating with insurance carriers, preparing claims, and overturning denials . * Communication : Exceptional verbal and written skills; able to… more
- Aftermath Billing (Port Saint Lucie, FL)
- …health of our clients by working to resolve billing issues, processing denials , and facilitating collections in compliance with all applicable regulations. Key ... companies to ensure timely payment. Investigate and resolve claim denials or payment discrepancies. Maintain accurate documentation of collection activities… more
- Emanate Health (Covina, CA)
- …required. Experience includes: hospital billing and collection experience such as clinical denials or reference to a denials management department. Thorough ... knowledge of medical terminology and coding. **Minimum License Requirement:** None Delivering world-class health care one patient at a time. Pay Range: $25.53 - $38.29 We are more than just a health system. At Emanate Health, we are a catalyst for change and a… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …entity/general ledger account using designated adjustment codes. Processes payments and denials with the correct denial/remittance codes and applies denials ... /payments to the appropriate account/liability bucket. Handles processing of Non-Sufficient Funds (NSF) payments. Conducts in-depth research to resolve any balancing issues or to reconcile unidentified payments posted to clearing accounts. Identifies issues… more
- University Health (San Antonio, TX)
- …programs and tracks case-specific assistance provided in response to reimbursement denials . Conducts patient interviews and conveys reimbursement denial potential to ... patients and medical staff. Reviews all outpatient 3rd party rejections and assists the patient in resolving the problem. Coordinates 3rd party billing, problems with eligibility, rejections, etc. with the Outpatient Pharmacy Supervisor and the Pharmacy… more
- Cameo Dental Specialists (Lagrange, IL)
- …revenue cycle functions, including charge entry, payment posting, A/R follow-up, and denials management in accordance with the center's policies and procedures. This ... role plays a key part in ensuring accurate financial processes, timely reimbursements, and overall operational efficiency. Schedule: Full Time at our LaGrange location Responsibilities Liaise with insurance providers to clarify patients' coverage and resolve… more
- DERMCARE MANAGEMENT LLC (Shingle Springs, CA)
- …Works closely with Revenue Cycle to ensure A/R is optimally liquidated, denials are minimized, refunds are issued, PENDI's are addressed, charts are closed ... timely, and questions promptly answered to the billing & claims team. Works closely with Credentialing & Enrollment to ensure all business and provider licenses are paid, up to date and in good standing and that all available enrollments are completed and… more
- Clever Care Health Plan (Huntington Beach, CA)
- …Prepare all correspondence related to credentialing status, including approvals, denials , and appeal communications. Support provider onboarding processes in ... coordination with Provider Services and other internal departments. Participate in audit preparation and corrective action plans relating to credentialing functions. Ensure all providers and facilities in the network meet regulatory and risk management… more
- NATIONAL PARTNERS IN HEALTHCARE (Richardson, TX)
- …pertain to all phases of operations including billing, claims, claim denials , payments, and collection activities. Records all customer contacts, including ... resolution or forwarding action taken to refer question to proper party. Whenever possible, resolves question directly so that patient receives prompt satisfaction. Explains account situation accurately in simple language so that patient can understand the… more
- Seattle Children's (Seattle, WA)
- …follow-up in order to reduce or limit the opportunity for audit-related payment denials . The Audit Management Analyst will have responsibility and oversight of the ... claim audit appeal process as well as analyze and provide reports addressing audit trends across payers and vendors. This role will also be tasked with developing recommendations to mitigate revenue loss. **Required Education and Experience** Bachelor's degree… more
- US Physical Therapy (Big Rapids, MI)
- …prior authorizations and verify coverage + Follow up on unpaid claims and denials + Maintain accurate and up-to-date patient account information + Provide excellent ... customer service to patients and healthcare providers + Collaborate with other departments to improve processes and ensure timely reimbursement + Maintain knowledge of current insurance regulations and coding requirements **Qualifications** + High school… more
- Centers for Independence (Milwaukee, WI)
- …aging for assigned programs and follow up on outstanding balances and denials , working with programs and customer inquiries to obtain additional information, if ... needed, to reprocess claims/invoices for payment. + Responsible for filing/scanning all relevant documents + Provides backup to the Billing Specialist I, Cash Application Specialist & Follow-up Specialist as appropriate and/or as directed by the Accounts… more
- Capco, a Wipro Company (Orlando, FL)
- …+ Confirm sound underwriting decisions regarding loan approval, conditions, or denials based on comprehensive risk analysis. + Provide guidance, training, and ... support to department staff. + Collaborate with clients to resolve underwriting issues and clarify loan conditions. + Stay updated with changes in mortgage lending regulations, investor requirements, and industry best practices. + Maintain accurate records of… more
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