- Stanford Health Care (Palo Alto, CA)
- …Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials . This position requires ... and opportunities for improvement. + Maintains accurate records of appeals and denials for tracking and reporting...with Management: Identify and escalate denial patterns to the Manager of Government Audits and Appeals , providing… more
- MVP Health Care (Rochester, NY)
- …Monitor service utilization to maintain cost-effectiveness and manage Medical Loss Ratio (MLR). Appeals & Denials : Participate in the appeals process for ... innovative thinking and continuous improvement. To achieve this, we're looking for a Case Manager , Medicaid Long Term Support Program to join #TeamMVP. If you have a… more
- Sun Pharmaceuticals, Inc (Syracuse, NY)
- …expertise in access and reimbursement issues encompassing coverage, prior authorizations, appeals , exceptions, denials , coding and payer payment guidelines , ... The Field Reimbursement Manager is part of the Market Access group...to access Sun portfolio of products. The Field Reimbursement Manager will interact with access services hub, managed markets… more
- Alameda Health System (San Leandro, CA)
- SLH Case Manager RN + San Leandro, CA + San Leandro Hospital + SLH Social Services + Part Time - Day + Care Management + $58.74 - $97.91 per hour + Req #:42605-31625 ... + FTE:0.7 + Posted:August 6, 2025 **Summary** **JOB SUMMARY** The SLH Case Manager RN is responsible for providing comprehensive case management services to clients… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …will be responsible for evaluating and responding to clinical and administrative denials referred to Case Management Department for appeal. You will participate in ... + Work with insurance carriers and MSKCC billing departments to initiate appeals and acquire authorizations for treatment **Key Qualifications:** + Current NYS… more
- Jobleads-US (Chicago, IL)
- …contractual or administrative write-off and provide appropriate justification and documentation. Denials and appeals follow-up including root cause analysis to ... Identifies patterns of billing errors and works collaboratively with department manager and outside entity to improve processes as needed. Provides guidance… more
- Emanate Health (Covina, CA)
- …Specialist is responsible for denial and AR management as defined by Denial Manager . The Denial Specialist will possess and apply thorough knowledge of collections ... of a patient account that is involved in the audit and appeals process to accurately complete accounts receivable reconciliation. **Minimum Education Requirement:**… more
- Stanford Health Care (Palo Alto, CA)
- …variances and pursuing underpayments to payers + Reviewing and resolving payer rejections, denials , and performing appeals as necessary + Electronic or hardcopy ... - Payer clerical and technical denial review and request processing including basic appeals - Payment posting and batch reconciliation - Credit balance review and… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …Degree 2 years of experience - hospital billing, processing claim edits, denials , appeals and managing accounts receivable. Experience with Epic Resolute ... CHFP (Certified Healthcare Financial Professional) CPAM (Certified Patient Account Manager ) CPAT (Certified Patient Account Tech) **The current salary range… more
- Nuvance Health (Danbury, CT)
- …departments, team members, providers, delegates, and community partners. In addition, the Manager Denials Prevention & Appeals Operations is responsible ... and provide coaching and feedback to team members. * Collaborate with Manager Denials Prevention & Appeals Administration to oversee UR processes for… more
- Garnet Health (Middletown, NY)
- …is responsible for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate ... overall quality, completeness, and accuracy of medical record documentation. The Manager will evaluate denials and work closely with the outcomes manager and… more
- Catholic Health (Buffalo, NY)
- …hours based on role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for the people, carrying ... a liaison between front-end clinical areas and third-party payers in scenarios related to denials and appeals . This position educates all members of the patient… more
- Hartford HealthCare (Farmington, CT)
- …review of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials , ... multiple denials , prioritize tasks, and ensure timely submission of appeals . . Experience with electronic health record (EHR) systems, coding software, and… more
- Beth Israel Lahey Health (Plymouth, MA)
- …making a difference in people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth ... Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs...Reviews and determines appropriate strategy in response to reimbursement denials . + Responsible for appeals and follow… more
- Robert Half Accountemps (Fort Worth, TX)
- Description We're seeking an experienced Infusion Billing and Denials Specialist to join a growing healthcare organization. This role will play a key part in ... stabilizing and improving the infusion billing process, managing claim denials , and supporting the transition to an in-house billing model. The ideal candidate… more
- Guidehouse (Birmingham, AL)
- …to resolve claim denials and account balances. + Performing Non-Clinical Appeals . + Assisting Supervisor/ Manager as needed with various projects. + Escalate ... expert can effectively resolve the matter. + Communicate to Supervisor/ Manager areas of concern or areas of improvement. +...+ 0-2 years medical billing experience working with UB04, appeals & denials . **What Would Be Nice… more
- Mohawk Valley Health System (New Hartford, NY)
- Supervisor, Denials Mgmt & Efficiency - Hybrid Flexible Department: ACCTS RECEIVABLE & COLLECTION Job Summary The Supervisor of Denials Management and Efficiency ... operational excellence within the Billing Office by improving workflows, reducing denials , and fostering collaboration across MVHS. This position leads a focused… more
- BronxCare Health System (Bronx, NY)
- Overview Assists in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute ... action in order to improve outcomes. - Maintains an excel log related to denials / appeals activities in order to monitor successful appeals . - Assists with… more
- Beth Israel Lahey Health (Charlestown, MA)
- …difference in people's lives.** This is a remote based role. Reporting to the Manager , Patient Financial Services, the Clinical Analyst plays an important role in a ... high-profile team tasked with handling all commercial and government clinical appeals and audit processes. The Clinical Analyst will perform high-level clinical… more
- Catholic Health Services (Melville, NY)
- …services and coordinates utilization/ appeals management review. + Assist Utilization and Appeals Manager in setting up communications with payors and/ or ... accurate utilization data in a timely fashion. + Monitors denials as well as all financial metrics associated with...departments. + Develops/validates daily work lists for Utilization and Appeals Manager . + Assist with all insurance… more
