- 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
- MCG Health System (Augusta, GA)
- Denials and Appeals Specialist Work Location: Satellite Location Req Number: 35021 Department Name: Prof Rev Cycle Svcs Shift: Days/No Weekends Position ... positions, returnto the Search Results or Job Cart. Position Description The Denials and Appeals Specialist is responsible for timely and accurate resolution… more
- Sanford Health (Sioux Falls, SD)
- …of documentation, interpretation of policies, and handling of correspondence related to denials and appeals submitted by providers and members. Must administer ... a demonstrated understanding of regulatory requirements and timeframes. Intake and coordinate appeals and denials , and then make determinations based on member… more
- TEKsystems (Plano, TX)
- Required: + 2+ years of Insurance follow-up, denials / appeals experience (Medical A/R) + Hospital/facility collections experience Description: Responsible for ... Responsible for managing CBO Aging Report properly to insure appeals are followed up timely to prevent past filing...Responsible for timely medical records requests and submission of appeals * Maintain adequately trained staff to achieve daily… more
- Trinity Health (Farmington Hills, MI)
- …Payment Resolution with communication and follow-up processes related to rejections, denials and appeals , ensuring that such activities are tracked, ... Work Remote Position (Pay Range: $34.9314-$52.3971) Responsible for reviewing all post-billed denials (inclusive of clinical denials ) for medical necessity and… more
- 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
- Trinity Health (Farmington Hills, MI)
- …Maintains knowledge of state/federal laws as they relate to contracts and the appeals process. Assists in training Payment Resolution Specialist I colleagues ... location. The scope of responsibility will be all post-billed denials (inclusive of clinical denials ). Serves as...as to ensure timely follow-up and action for account appeals . + Works with Patient Access and other necessary… more
- Fairview Health Services (St. Paul, MN)
- **Overview** The Physician Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by the ... pertaining to billing, coding, and documentation. The Physician Coding Denials Specialist will also handle audit-related and...appeals or re-billing of claims to resolve coding denials to ensure collection of expected payment and mitigation… more
- Rush Copley Medical Center (Aurora, IL)
- **Position Summary** : The Appeals Specialist RN reviews inpatient hospital denials , clinical validation requests, and upheld denials after ... to details, and self-motivated. **Experience** + Knowledge/experience in utilization management, denials and/or appeals management in hospital or physician … more
- HCA Healthcare (Largo, FL)
- …**Introduction** Do you want to join an organization that invests in you as an Appeals Specialist ? At Parallon, you come first. HCA Healthcare has committed up ... make a difference. We are looking for a dedicated Appeals Specialist like you to be a...for reconsiderations. + Identify contract protection to leveraged overturn denials . + Argue appeals that prevent claim… more
- HCA Healthcare (Brentwood, TN)
- …a work environment where diversity and inclusion thrive? Submit your application for our Appeals Specialist opening with Parallon today and find out what it ... benefits may vary by location._** We are seeking a Appeals Specialist for our team to ensure...for reconsiderations. + Identify contract protection to leveraged overturn denials . + Argue appeals that prevent claim… more
- SSM Health (MO)
- …**Job Highlights:** We are seeking a highly skilled and detail-oriented Coder for Hospital Denials to join our team at SSM Health. You will be responsible for ... reviewing medical records and accurately coding diagnoses and procedures for hospital denials . This role requires strong analytical skills, attention to detail, and… more
- Universal Health Services (Bonham, TX)
- …is managed by Texoma Medical Center, subsidiary of UHS. The Appeals Specialist is responsible for appealing all insurance denials and prepare relevant ... in compliance with Managed Care contracts and government fee schedules. The Appeals Specialist will obtain, manipulate, and analyze data from a variety of… 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
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES & ESSENTIAL JOB...Management team when cases do not meet criteria; coordinates denials with the attending physician and the Care Management… more
- St. Luke's University Health Network (Allentown, PA)
- …clean claim submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across the network. Utilizes ... coding errors and MUE frequency for clean claim submission + Resolve coding denials through claim correction or appeal. Claim corrections will be made after review… more
- University of Virginia (Charlottesville, VA)
- …analyzes accounts receivable and takes appropriate action to resolve coding and global denials . + Posts denials /rejects into EPIC billing system. + Works complex ... denials with a high degree of accuracy and timeliness. Responds to inquiries from patients, clinical departments, and third parties by way of telephone, written correspondence and personal contacts. + Adds/corrects registration, insurance, and demographic… 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
- Hartford HealthCare (Farmington, CT)
- …and homecare to insure optimal revenue cycle performance. The AR Follow Up & Denials Specialist is responsible for resolving unpaid third party balances on $550 ... million in active inventory and $70 million in denials through account follow up, appeals and resubmission actions. This position reports directly to the AR… more
- Hackensack Meridian Health (Hackensack, NJ)
- …information for appeals of Managed Care audits, clinical and technical denials by utilizing various Epic and legacy systems for Hackensack Meridian Health (HMH) ... as a leader of positive change. The **Appeal Nurse Specialist ** will be responsible for the timely review and...be responsible for the timely review and submission of appeals for denied managed care inpatient and/or outpatient claims… more