- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial ... and payers to successfully clear front end claim edits, appeal clinical denials , and address customer service inquiries. Additionally, this position will collaborate… 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 for medical ... and tracks outcomes regarding appeal process. Assists billing staff regarding outpatient denials for experimental, coding or other issues that may require record… more
- Fairview Health Services (St. Paul, MN)
- …preparing and submitting appropriate appeals or re-billing of claims to resolve coding denials to ensure collection of expected payment and mitigation of denials ... among all department managers, staff, physicians and administration with respect to coding denials issues. + Assists with the development of denial reports and other… more
- ClearChoiceMD (Concord, NH)
- …and understand the need for excellent, expedient care. The Accounts Receivable Denials Specialist is a member of the ClearChoiceMD/CareWell Urgent Care billing team. ... an internal company role responsible for working all payer denials . This role will work directly in Waystar and...Experity to work and review all rejection and payer denials . The Accounts Receivable Denialist Specialist will also review… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a difference in people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth Israel ... Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance regarding UR and the… more
- R1 RCM (Salt Lake City, UT)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As a ** Denials Rules** **-** **Senior Rules Architect** , you will help the ... company by expanding the scope, accuracy and impact of Denials Rules across several Service Lines. Every day, you...and the Rules team to expand the impact of Denials Rules and drive change through efficiency and process… more
- Northern Montana Hospital (Havre, MT)
- Revenue Cycle Denials Management Specialist - FT The Revenue Cycle Denial and Underpayment Specialist presents, analyzes, and trends denial and underpayment data to ... lines for the purpose of recovering revenue and appealing denials . The analyst also identifies root causes and denial...by implementing process improvements to reduce the frequency of denials , reviews managed care contracts and comparison of such… more
- Catholic Health (Buffalo, NY)
- …of root cause and process improvement opportunities to eliminate recurring clinical denials . The position acts as a liaison between front-end clinical areas and ... third party payers in scenarios related to denials and appeals. This position educates all members of...on an ongoing basis in relation to trends in denials , and clinical documentation. Responsible for working alongside coding,… more
- CommonSpirit Health (Phoenix, AZ)
- …needs of patients and alternative levels of care. **The PA performs denials management and prevention in accordance with the organization's goals and expectations. ... addresses concerns raised by the payer, and provides additional context to overturn denials before escalation to formal appeal. + Reviews and analyzes denied claims… 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 clinical leadership and administrative guidance to the Clinical Revenue Cycle department.… more
- Penn Medicine (Lancaster, PA)
- …life's work? Summary: + Position Summary: The Utilization Management Specialist - Denials is responsible for evaluating medical records to determine severity of ... minimize denied days. + Complete all documentation, including authorizations and denials according to departmental standard operating procedures. + Communicate with… more
- R1 RCM (Detroit, MI)
- …analytics, AI, intelligent automation, and workflow orchestration. As our Complex Denials Consultant, you will represent healthcare providers in their disputes with ... and federal laws, writing appeals and letters to insurance companies to resolve denials , and reviewing high-balance or complex accounts. To thrive in this role, you… more
- Catholic Health Initiatives (Omaha, NE)
- …to address and resolve outstanding insurance balances related to coding denials in accordance with established standards, guidelines and requirements. The incumbent ... to detail and the application of analytical/critical thinking skills to analyze denials and reimbursement methodologies to bring timely resolution to issues that… more
- UTMB Health (Galveston, TX)
- Patient Account Specialist - Revenue Cycle HB Billing & Denials **Galveston, Texas, United States** **New** Business, Managerial & Finance UTMB Health Requisition # ... procedures. + Responds to daily correspondence according to procedures. + Identifies denials and underpayments for appeal. + Reviews, researches and processes denied… more
- UTMB Health (Galveston, TX)
- Senior Patient Account Specialist - Revenue Cycle HB Billing & Denials **Galveston, Texas, United States** **New** Business, Managerial & Finance UTMB Health ... procedures + Responds to daily correspondence according to procedures + Identifies denials and underpayments for appeal + Reviews, research, and processes denied… more
- TEKsystems (San Bernardino, CA)
- Description The ideal candidate will be responsible for managing clinical denials related to medical necessity, level of care, and delays in service. This role ... of experience in reviewing medical records 1+ years of experience in appeals and denials High School Diploma On-Site Monday- Friday 8-5 Pay and Benefits The pay… more
- Texas Health Resources (Arlington, TX)
- …a top-notch health care company? We're looking for a qualified_ **Coder II ( Denials )** _like you to join our Texas Health family._ **Position Highlights** + Work ... (eg, Charge correction requests, research of payor policies, Accounts Receivable & Denials management of Profee charges) **Additional perks of being a Texas Health… more
- Vanderbilt University Medical Center (Nashville, TN)
- …in patient care, education, and research. **Organization:** PB Claims/Follow Up/ Denials /Ps **Job Summary:** JOB SUMMARY Manages the technical and/or professional ... revenue cycle. Oversees daily operations of billing, collection and payment process. . KEY RESPONSIBILITIES * Continuously improves revenue cycle while enhancing service to patients and optimizing relationships with business partners and vendors. * Ensures… more
- Ochsner Health (New Orleans, LA)
- …Financial Counseling, Call Center, Billing, Collections/Follow-Up, Self-Pay, Credentialing, Denials . Ensures the financial security of accounts for Ochsner ... patients in various ways; assumes responsibility for working and advising patient of their financial responsibility whether it is a patients self pay, co-payment or deductible; ensures the financial security of Ochsner patient accounts by carrying out one of… more
- Rochester Regional Health (Rochester, NY)
- SUMMARY: Denials ManagementThe C & D specialist is responsible for reviewing accounts which have been denied or underpaid by third party payers and to resolve the ... issues resulting in denial/underpayment and to formally appeal. The specialist will conduct comprehensive reviews of clinical documentation to determine if an appeal is warranted. Should an appeal be necessary, the specialist will write compelling and factual… more
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