- Saratoga Hospital (Saratoga Springs, NY)
- …Patient Access (PA) and Patient Financial Services (PFS). The Denials Specialist is responsible for tracking denied HIS inpatient accounts, working with ... Under general supervision of the Manager, Health Information Services, the Denials Specialist performs activities to ensure appropriate financial reimbursement… more
- Fairview Health Services (St. Paul, MN)
- **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by ... payer requirements pertaining to billing, coding, and documentation. The Inpatient Coding Denials Specialist will also handle audit-related and compliance… more
- St. Luke's University Health Network (Allentown, PA)
- …communities we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party ... geography after orientation. JOB DUTIES AND RESPONSIBILITIES: + Reviews all Inpatient Retroactive Denials in the Denials Management Work Queues for Medical… more
- Hartford HealthCare (Farmington, CT)
- …**Job:** **Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 2 / HIM Coding* **Location:** ... and other common practices across the system.*__* *_Position Summary:_* The Denial Specialist 2 is responsible for reviewing, analyzing, and appealing denials … more
- Houston Methodist (Sugar Land, TX)
- …for data gathering on medical resource utilization, and, as appropriate, resolution of inpatient denials , as well as other tasks related to reimbursement or ... At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Medical Billing & Denials Specialist Department: Patient Financial ServicesLocation: Massena HospitalHours Per Week: 40Schedule: Monday - Friday ... 8AM-4PM SUMMARY: A Medical Billing and Denials Specialist is responsible for managing the...+ Medical Billing Expertise: Proficient in billing, claims processing ( Inpatient , Outpatient, Critical Access, Rural Health), denials … more
- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ... internal leadership for assistance in resolution. *Responsibilities:* * Review all inpatient admission and observation cases using InterQual, or Milliman Care… more
- Cognizant (Phoenix, AZ)
- …advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process includes ... analyzing, reviewing, and processing medical necessity denials for resolution. You will be a valued member.... Epic experience . Experience in drafting appeals disputing inpatient clinical validations audits is a plus. We're excited… more
- Catholic Health (Buffalo, NY)
- …based on role of management and oversight of team Summary: The Clinical Denials and Appeals, Clinical Supervisor is responsible for the people, carrying out and ... limited to clinical documentation/support for diagnostic related grouping (DRG) assignment, inpatient and outpatient medical necessity. The individual also works to… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for accuracy ... to improve coding practices and compliance. **Essential Functions** + Performs inpatient denial reviews using ICD-10-CM/PCS and DRG validation utilizing appropriate… more
- Select Medical (West Orange, NJ)
- …for this job (https://jobs-selectmedicalcorp.icims.com/jobs/339844/prior-authorization- specialist inpatient ... - West Orange** A Select Medical Hospital West Orange, NJ **Prior Authorization Specialist / Payor Relations Specialist ( RN , LPN )** **Full-Time** **Onsite… more
- Independent Health (Buffalo, NY)
- …fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on ... share knowledge and audit tips across the team. The Clinical & Coding Specialist -Senior will support the leadership in Hospital Audit in accomplishing all aspects of… more
- Trinity Health (Livonia, MI)
- …to support diagnosis code and MS-DRG, APR DRG assignments to potentially decrease denials . 5. Works Inpatient claim edits and may code consecutive/combined ... competency and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary… more
- Veterans Affairs, Veterans Health Administration (Jackson, MS)
- …criteria). Grade Determinations: Medical Records Technician (Clinical Documentation Improvement Specialist (CDIS-Outpatient and Inpatient )), GS-9 (a) Experience. ... documentation and provides education to clinical staff on both inpatient and outpatient episodes of care including admissions and...efforts are conducted to ensure the accuracy of billing denials and prevention against fraud and abuse and to… more
- University of Washington (Seattle, WA)
- …or more content areas ERHI has coding oversight for Serve as an expert in Inpatient coding , respond to general coding questions (ICD, DRG, CPT and HCPCS), engage in ... with Compliance on external audit education + Review DRG and CPT claim denials for commercial payers and maintain written documentation of actions, activities or… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Clinical Documentation Integrity Specialist Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's ... be named a Forbes "Best Employer" seven times. Position Summary: The CDI Specialist serves as liaison between the physicians and hospital departments to promote… more
- Robert Half Accountemps (Alhambra, CA)
- Description A Hospital in Los Angeles is seeking a Medical Collections Specialist with experience in credit balances. The Medical Collections Specialist must be ... tracking, and resolving denied medical insurance claims. The Medical Collections Specialist must have 2 years medical billing and medical insurance collections… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …supervision of the Director of Patient Financial Services, the Clinical Appeals Specialist performs advanced level work related to clinical denial management. The ... individual is responsible for managing medical denials by conducting a comprehensive review of relevant clinical documentation. The Clinical Appeals Specialist … more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Procedural Billing Specialist I is responsible for multiple components of the complex billing and coding process for specialized procedures, ... to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator. Reports to Billing Manager/Revenue… more
- UPMC (Pittsburgh, PA)
- …If so, we want you to be part of our team as an Authorization Specialist at UPMC Hillman Cancer Center! At UPMC, we're committed to providing exceptional oncology ... care to our community. As an Authorization Specialist , you'll play a vital role in ensuring that...commitment to making a difference. Key Responsibilities: + Manage denials and oversee all revenue functions. + Demonstrate a… more