- Hartford HealthCare (Farmington, CT)
- …**Job:** **Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 2 / HIM Coding* **Location:** ... review of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials ,… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... and denials for no authorization. The Senior Denials Management Specialist position communicates clinical information...contracts and coordination of benefits related to coverage, clinical appeals , and denials to include knowledge of… more
- 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 ... functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** +...of the following: + * CCS - Certified Coding Specialist (AHIMA) + * CPC - Certified Professional Coder… 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 ... and rejections. + Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and impact on revenue and trending. +… more
- Colorado State University (Fort Collins, CO)
- Posting Detail Information Working TitleInsurance Denials Specialist Position LocationFort Collins, CO Work LocationPosition qualifies for hybrid/in-office work ... and a thriving arts and entertainment industry. Position Summary The Insurance Denials Specialist will provide excellent customer service and guidance to… more
- HCA Healthcare (San Antonio, 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
- PeaceHealth (Vancouver, WA)
- **Description** PeaceHealth is seeking a Coding Denials Specialist . This position is remote but does require the associate to live / work in OR, WA, AK or TX to ... be eligible for consideration. **Job Summary** Coding Denials Specialist analyzes, processes, and resolves claim denial requests. Provides support to HIM Coding… more
- CenterWell (Honolulu, HI)
- …a part of our caring community and help us put health first** The ** Denials Management Specialist ** is responsible to respond to, monitor and analyze all ... managing and monitoring all payer requests for additional documentation (ADR), appeals and denials . Works with branch staff to gather required information and… more
- ClearChoiceMD (Concord, NH)
- …know and understand the need for excellent, expedient care. The Accounts Receivable Denials Specialist is a member of the ClearChoiceMD/CareWell Urgent Care ... typical day in the life of an Accounts Receivable Denials Specialist , includes: + Responsible for Waystar...needed to resolve claim denial + Responsible for processing appeals , identifying trends, and researching denials of… more
- HCA Healthcare (Richmond, VA)
- …individual is recognized. Submit your application for the opportunity below: Clinical Denials Coding Review Specialist Parallon. **Benefits** Parallon, offers a ... **_Note: Eligibility for benefits may vary by location._** We are seeking a Clinical Denials Coding Review Specialist for our team to ensure that we continue… more
- Robert Half Accountemps (Los Angeles, CA)
- …A Medical IPA Group in Los Angeles is in the immediate need of a Grievance & Appeals Specialist . The Grievance & Appeals Specialist , will be in ... denied claims, complying with State/Federal laws, rules, and guidelines. The Grievance & Appeals Specialist will be expected to perform research and utilize your… more
- Molina Healthcare (Omaha, NE)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** **Job Summary** Responsible for reviewing... appeals and denials . + Strong verbal and written communication skills +… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... or identification of trends. Assists in preparing reports regarding denials to include volumes, number of appeals ,...regarding denials to include volumes, number of appeals , case resolution, and impact on revenue and trending.… more
- St. Luke's Health System (Twin Falls, ID)
- …work. **What You Can Expect:** Under limited supervision, the Clinical Appeals Specialist , is responsible for managing client medical denials by conducting a ... sources to provide and maintain a single reporting location that reflects clinical denials and appeals activity. + Recommends improvements and modifications to… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... or AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and… more
- Texas Health Resources (Arlington, TX)
- …and providers related to issues identified with root cause analysis of the denials and appeals process Manage/Troubleshooting for high priority clinics as ... **Manager Billing Coding and Denials ** _Are you looking for a rewarding career...certifications are required upon hire)** CCS-P - Certified Coding Specialist -Physician based CPC - Certified Professional Coder CPB -… more
- Elevance Health (Irving, TX)
- …our specialty pharmacies, our infusion centers, and the home setting._ **Referral Specialist II/Patient Access (Pre & Prior Authorizations, Appeals , Insurance) - ... weeks/30 days at the Plano, TX office. The **Referral Specialist II** is responsible for providing support to a...necessary. + Ability to initiate pre-determination, prior authorizations, and appeals for denials based on payer policy.… more
- Cardinal Health (Fresno, CA)
- …the patient's account balance is zero. **_Job Summary_** The Coding Denial Specialist is responsible for reviewing, analyzing, and resolving medical claim denials ... HCPCS coding to support appropriate reimbursement and reduce denial rates. The specialist collaborates closely with billing, coding, clinical teams, and payers to… more
- Johns Hopkins University (Middle River, MD)
- …issues and facilitate prompt payment of claims. Communicates with providers regarding appeals and medical policy denials and provides appropriate proactive ... related to specialized, complex or high-cost procedures. + Contacts providers regarding appeals and medical policy denials , identifies and collects additional… more
- Houston Methodist (Houston, TX)
- …This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the ... At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect...queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits… more
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