- R1 RCM (Detroit, MI)
- …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you ... this remote production-drive position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical… more
- Trinity Health (Farmington Hills, MI)
- …**Description:** **POSITION PURPOSE** Work Remote Position (Pay Range: $39.8218-$59.7327) Applies clinical and comprehensive payer and appeals knowledge in ... review and resolution of claim escalations. Responsible for leveraging clinical and broad payer and appeals knowledge,...in the most timely manner possible: + Supports Supervisor Clinical Payment Resolution or Manager Clinical / Coding… more
- Trinity Health (Farmington Hills, MI)
- …and determining root causes of clinical denials. Responsible for leveraging clinical knowledge and standard procedures to track appeals through first, ... best practices. The position will report directly to the Supervisor Clinical / Coding Payment Resolution. **ESSENTIAL FUNCTIONS** Knows, understands,… more
- Trinity Health (Farmington Hills, MI)
- …timeliest manner possible: + Coordinates follow-up activities with Utilization Review/Case Management/ Coding / Nurse Liaison to provide required clinical ... location. The scope of responsibility will be all post-billed denials (inclusive of clinical denials). Serves as part of the Payment Resolution team at an assigned… more
- Trinity Health (Farmington Hills, MI)
- …timeliest manner possible: + Coordinates follow-up activities with Utilization Review/Case Management/ Coding / Nurse Liaison to provide required clinical ... of responsibility will be all post-billed denials (inclusive of clinical denials). Serves as part of a team of...state/federal laws as they relate to contracts and the appeals process. Assists in training Payment Resolution Specialist I… more
- Trinity Health (Livonia, MI)
- …and refers findings for appropriate follow-up. 15. Reviews IP denials with the appeals nurse to determine appropriate status and reimbursement from payer. Appeal ... data gathering for identified projects, internal audits, retrospective reviews, statistics, coding , billing or verification issues. The UR Coordinator I will be… more