- Trinity Health (Farmington Hills, MI)
- …activities as part of the payment resolution team that receives, analyzes, and appeals denials received for an assigned PBS location. Reviews, researches and ... Business Services (PBS) location. The scope of responsibility will be all post-billed denials (inclusive of clinical denials ). Serves as part of the Payment… more
- Randstad US (Dallas, TX)
- medical appeals and denials specialist. + dallas , texas + posted april 30, 2024 **job details** summary + $20 - $20.93 per hour + temp to perm + high school + ... style, then look no further. Must have at least 2 years of backend appeals and denials experience. salary: $20 - $20.93 per hour shift: First work hours: 8 AM… more
- Trinity Health (Farmington Hills, MI)
- …Patient Business Services (PBS) location. The scope of responsibility will be all post-billed denials (inclusive of clinical denials ). Serves as part of a team ... knowledge of state/federal laws as they relate to contracts and the appeals process. Assists in training Payment Resolution Specialist I colleagues upon hire… more
- BrightSpring Health Services (Louisville, KY)
- …to improve clinical documentation and minimize lost revenue. They conduct analysis on denials and appeals and identify trends that present process improvement ... requirements + Extensive experience in working with Payer requirements, ADR requests, Denials , Appeals , RAC/ZPIC responses + Ability to prioritize tasks and… more
- Houston Methodist (Houston, TX)
- …coding staff; and functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** + Communicates openly in a ... At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial… more
- HCA Healthcare (Largo, FL)
- …daily assignments. Contact facilities, physician offices, and insurance companies to resolve denials and appeals . Assess CPT codes for outpatient accounts that ... licensure Healthcare experience in an acute care hospital Utilization Review, appeals , denials , managed care contracting experience preferred Currently licensed… more
- HCA Healthcare (Largo, FL)
- …as appropriate. Contact the facilities, physician offices, and insurance companies to resolve denials and appeals . What qualifications you will need: High School ... of related experience required in the following area(s) required: appeals , denials , managed care, verifications/notifications, precertification. **Parallon**… more
- TEKsystems (Houston, TX)
- …formulating responses in writing to members. + Inbound member & provider calls for denials , appeals and peer to peer scheduling. + Initiation of appeals ... Hiring For Grievance & Appeals Coordinator! 100% REMOTE - Texas Note: Candidates...are having 5+yrs of experience in Medical Grievance and Appeals can only apply! Pay - $20/hr and up… more
- Community Health Network (IN)
- …Supports an environment of team work * Clear understanding and working knowledge of payer denials and appeals process * Ability to work independently as well as ... Patient Account Denials Assist Job Ref 2401430 Category Professional &...Remote / Work from Home / Virtual Department Clinical Denials Schedule Full-time Facility Indianapolis 100 Monument Circle Indiana,… more
- HCA Healthcare (Nashville, TN)
- …external) as needed for additional information to properly formulate and evaluate clinical appeals . + Determine root cause of denials and apply company-specific ... of federal, state and local rules and regulations impacting denials and + appeals . **What qualifications you will need:** + Associates Degree preferred… more
- Penn State Health (Hershey, PA)
- …State Health Community Hospitals. This will include all Pre-pay and Post-pay audit denials . The appeals nurse will subsequently draft any required appeals ... at ###@pennstatehealth.psu.edu 100% Remote Position **SUMMARY OF POSITION:** The clinical appeals nurse will be responsible for reviewing all clinical validation/DRG… more
- Molina Healthcare (NM)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers... appeals and denials . + Strong verbal and written communication skills To… more
- HCA Healthcare (Largo, FL)
- …denial arguments for reconsiderations. + Identify contract protection to leveraged overturn denials . + Argue appeals that prevent claim payment and gain ... join an organization that invests in you as an Appeals Specialist? At Parallon, you come first. HCA Healthcare...make a difference. We are looking for a dedicated Appeals Specialist like you to be a part of… more
- HCA Healthcare (Brentwood, TN)
- …denial arguments for reconsiderations. + Identify contract protection to leveraged overturn denials . + Argue appeals that prevent claim payment and gain ... diversity and inclusion thrive? Submit your application for our Appeals Specialist opening with Parallon today and find out...benefits may vary by location._** We are seeking a Appeals Specialist for our team to ensure that we… more
- Rush Copley Medical Center (Aurora, IL)
- This position reviews initial clinical facility and physician denials , documents appeals or clinical inpatient denials , conducts appeals as appropriate. ... coders, insurance companies and revenue cycle leadership to prevent future clinical denials by communicating denial root causes and help develop education and… more
- University of Michigan (Ann Arbor, MI)
- …independently. + Knowledge of healthcare regulations and compliance requirements + Experience in denials management and appeals is a plus **Work Schedule** This ... Inpatient Coding and Appeals Coordinator - Remote Apply Now **How to...regulatory requirements. They are responsible for reviewing and resolving denials related to inpatient services by evaluating and rectifying… more
- Guthrie (Binghamton, NY)
- …trending reports and reports reflecting recovery activity relative to requests, responses, appeals , denials and recoupments. The Coordinator will establish and ... Summary The Payor Audits and Appeals Coordinator will be responsible for monitoring timely...Coordinator will also be responsible for timely coordination of appeals and associated deadlines and reconciliation of payments and… more
- Randstad US (Woodland Hills, CA)
- …Grievance and Appeals Coordinators. Must be experienced with grievance and appeals , claim denials , medical terminology and CPT codes. Previous Grievance and ... grievance and appeals coordinator. + woodland hills , california +...copying, faxing and scanning incoming mail Skills + Claim Denials + CPT Codes Qualifications + Years of experience:… more
- R1 RCM (Salt Lake City, UT)
- …, you will help our hospital clients by serving as an expert on appeals and denials management where claims were denied by either governmental contractors ... patient care as well as conceptual knowledge of the denials landscape. Proficiency in basic computer skills is essential...**Here's what you will experience working as a Clinical Appeals Nurse:** + Conduct a detailed review of patient… more
- Beth Israel Lahey Health (Burlington, MA)
- …of America) Identifies, reviews, and interprets third party payments, adjustments and denials . Initiates corrected claims, appeals and analyzes unresolved third ... Assists the Billing Supervisor with the resolution of complex claims issues, denials , appeals and credits. 17. Works with cash team to resolve unapplied cash.… more
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