- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the ... DRG recoupments/downgrades, and denials for no authorization. The Senior Denials Management Specialist position communicates clinical information… more
- University of Southern California (Alhambra, CA)
- …federal & state coding compliance regulations and guidelines, the HIM Coding Denials Management Specialist " analyze, investigate, mitigate, and resolve ... this position will provide guidance and training to other HIM Coding Denials Management Specialist , and will assist with escalated issues. Essential Duties:… more
- Henry Ford Health System (Troy, MI)
- …resolution workflows, and assisting the supervisor with escalated issues. The CBO Coding Senior Specialist confirms the accuracy and completeness of coding to ... compliant claims are sent to payers. The CBO Coding Senior Specialist works independently to resolve complex...sending out clean quality claims and working and preventing denials . EDUCATION/EXPERIENCE REQUIRED: + High school diploma or GED… more
- Independent Health (Buffalo, NY)
- …Certified Clinical Documentation Specialist (CCDS), American Health Information Management Association (CCS-H, CCS-P), Certification Denials and Appeals ... that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist - Senior will be responsible for reviewing coding and clinical… more
- SERV Behavioral Health System (Hamilton, NJ)
- …a wide range of services. JOB SUMMARY: Reporting to the Billing Manager, the Senior Accounts Receivable Specialist will be responsible for billing and submitting ... claims and handling escalated billing and collection issues. The Senior Accounts receivable specialist serves as a subject matter expert in complex accounts… more
- University of Utah (Salt Lake City, UT)
- …PRN43493B **Job Title** Medical Coders **Working Title** Medical Appeal & Coding Specialist **Career Progression Track** S00 **Track Level** S3 - Skilled **FLSA ... May include contact with patients, families, doctors, or insurance companies. Senior -level support role. Completes assignments with little supervision. May assist… more
- Ascension Health (Glendale, WI)
- …specific experience required. **Additional Preferences** **Billing, A/R Follow Up, Denials Management experience preferred.** Personal vehicle, valid driver's ... **Details** + **Department:** Revenue Cycle Mgmt + **Schedule:** Monday-Friday / 8 hours per day. Hours will vary between 7AM-7PM depending on clinic needs. +… more
- Tufts Medicine (Burlington, MA)
- …setting (ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management , utilization review, denials management , or progressive leadership ... **Job Title:** Clinical Documentation Specialist III **Location:** 100% Remote **Certification and experience required for this role** **About Tufts Medicine:**… more
- Henry Ford Health System (Troy, MI)
- … senior Revenue Integrity leaders, the Revenue Integrity (RI) Specialist is responsible for multiple Revenue Integrity initiatives involving multiple clinical ... involving all appropriate personnel. Prepares reports and recommendations for management and coordinates implementation. The Revenue Integrity Specialist … more
- CaroMont Health (Gastonia, NC)
- … Management information to medical staff departments, Nursing departments, Care Management and Senior management as necessary. Retrospectively reviews ... attending physicians regarding utilization issues. Collaborates with discharge planning specialist and other disciplines. Retrospectively reviews discharged medical record… more
- US Physical Therapy (Bend, OR)
- …systems. + Resolve basic insurance issues and escalate complex cases to the Senior Insurance Specialist or Manager. + Communicate authorization and insurance ... **Company Description** **Job Description** The Insurance Verification & Authorization Specialist plays a vital role in ensuring that patient services are accurately… more
- MyFlorida (Naples, FL)
- OPS SENIOR CLERK - 64911252 Date: Nov 13, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 865189 Agency: Department of Health Working Title: OPS SENIOR CLERK - 64911252 Pay Plan: Temp Position Number: 64911252 Salary: $20/hour… more
- Albany Medical Center (Albany, NY)
- …Day (United States of America) Salary Range: $60,367.47 - $90,551.20 The Senior Hospital Coder is responsible for performing detailed coding quality audits, ... on staff and providing thorough education and feedback, projects assigned by management , and special requests to review coding for external departments such as… more
- Ventura County (Ventura, CA)
- …need and certification of skill. DEPARTMENT/AGENCY: Health Care Agency - Administration Senior Program Administrator is a Management classification and is not ... Certified Coding Supervisor - Health Information Management Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4892159) Apply Certified Coding Supervisor… more
- Sedgwick (Erie, PA)
- …policy and file material to make a proper coverage determination. + Partners with senior management on all major losses with significant indemnity or expense ... and drafts coverage letters to include both reservation of rights and coverage denials . + Handles claims in multiple jurisdictions; state laws and statutes vary, and… more
- Mount Sinai Health System (New York, NY)
- …experience are highly desirable. + Excellent interpersonal skills and experience working with senior management and other leaders, along with the ability to ... clinical care and medical billing and reimbursement. This position will report to the Senior Director. This role will serve as a crucial link in the revenue cycle,… more
- Texas Health Resources (Arlington, TX)
- …& Presentation - Prepare detailed audit reports and present findings to senior leadership, Texas Health management , and relevant committees, ensuring ... auditees, providers, and leadership to guide rebuttals, and establishing management correction plans when necessary. Additionally, the Compliance Auditor Manager… more
- Catholic Health Initiatives (Lufkin, TX)
- …**_License / Certification:_** Coding Certification through American Health Information Management Association (AHIMA) as Certified Coding Specialist (CCS) ... with limited oversight and may require direction from supervisor or more senior co-workers on complex cases. Accurately abstracts information from the service… more
- BayCare Health System (Tampa, FL)
- …trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior /RN responsibilities include:** + Functions as the ... assigned by the supervisor including but not limited to processing concurrent denials . + Preferred experience includes Critical Care or Emergency Nursing RN.… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …authorization submissions for timely response * Follows up on any prior authorization denials ; assists Utilization Management with appeals, as needed * Connects ... *_SUMMARY:_* We are currently seeking a*Prior Authorization Representative Senior *to join our**Financial Securing**team. This full-time role will primarily work… more