- Catholic Health Initiatives (Omaha, NE)
- …assigned facilities. The RN has an integral role within the revenue cycle by providing clinical expertise in the denials management process. The Denials RN ... findings to management. Recommends and provides education in collaboration with their manager . The Denials RN follows a standardized approach to managing… more
- St. Luke's University Health Network (Allentown, PA)
- …mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care ... regardless of a patient's ability to pay for health care . The Claim and Denial Coding Analyst role is...and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across… more
- Guidehouse (Birmingham, AL)
- …Companies to resolve claim denials and account balances. + Performing Non- Clinical Appeals + Assisting Supervisor/ Manager as needed with various projects. + ... Required** **:** None **What You Will Do** **:** The Central Denials Account Representative conducts thorough account reviews to determine the appropriate… more
- TEKsystems (Plano, TX)
- …on accounts. Including but, not limited to Managed Care , Reimbursement, Clinical , Admissions, Facility Business Office Manager , Coding, Case Management, HIM ... Required: + 2+ years of Insurance follow-up, denials /appeals experience (Medical A/R) + Hospital/facility collections experience Description: Responsible for A/R,… more
- Alameda Health System (San Leandro, CA)
- …made to discontinue the process; assumes the responsibility for coordinating and appealing clinical denials per department policy; develops any appeal letters to ... Care Management Clinical Appeals Specialist +...clinical guidelines; refers questionable cases to the CM Manager or physician advisor for determination. 3. Collaborates and… more
- WMCHealth (Warwick, NY)
- …formulates denials resolution strategies. + Works with the Follow-up Manager to establish and monitor accounts receivable management and cash collection ... Manager , System Patient Accounting Company: Good Samaritan Hospital...Automation is responsible for overseeing the billing, follow-up and denials management function at Bon Secours Charity Health System.… more
- LifePoint Health (Rutherfordton, NC)
- …services to communities. Duke LifePoint combines Duke's unparalleled expertise in clinical excellence and quality care with LifePoint's extensive resources ... gatekeeper of patients being admitted to the hospital by facilitating initiation of care starting.2. The ED Case Manager starts initiation and utilization… more
- Swedish Health Services (Edmonds, WA)
- **Description** ** Care Manager RN @ Swedish Edmonds** **Full Time (40 Hour Week)** **Day Shift** **8 Hour Shift** **$10,000 Hiring Bonus and relocation for ... opportunities for advancement. **Requsition ID:** 273956 **Company:** Swedish Jobs **Job Category:** Care Management **Job Function:** Clinical Care **Job… more
- AdventHealth (Glendale Heights, IL)
- …. The Social Work Care Manager ensures efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The ... Winthrop Ave, Glendale Heights, IL **The role you'll contribute:** The Social Work Care Manager intervenes with patients who have complex psychosocial needs,… more
- Huron Consulting Group (Chicago, IL)
- …to improve clinical outcomes and reduce the cost of providing patient care . Investing in new partnerships, clinical services and technology is not enough ... changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive… more
- AdventHealth (Orlando, FL)
- **Retail AdventHealth Primary Care Clinical Supervisor** **All the benefits and perks you need for you and your family:** . Commitment to whole-person care . ... Quality Assurance Program to monitor and control department services . Communicates to Clinical Manager all complaints and takes effective corrective action and… more
- Albany Medical Center (Albany, NY)
- …contract and works diligently toward the identification, mitigation, and prevention of clinical denials . In addition to contacting payers and providers via ... Payer database to ensure accuracy by Payer and Product line. + Reviews clinical denials including those related to pre-authorizations; work with Patient… more
- Intermountain Health (Layton, UT)
- …resources as necessary. + May provide psychotherapeutic modalities appropriate to the level of care under the supervision of a licensed clinical social worker. + ... Description:** Social Worker-Certified The Certified Social Worker (CSW) utilizes clinical expertise to perform psychosocial assessment and develop/ implement a… more
- Intermountain Health (Provo, UT)
- **Job Description:** Job Profile Summary The Nurse Case Manager utilizes clinical expertise and critical thinking skills to develop and implement a plan of ... any necessary information to payers to help appeal existing denials . Uses level of care criteria to...in which the nurse practices. + Three years of clinical nursing experience. + Basic computer skills and knowledge… more
- HCA Healthcare (Denver, CO)
- … denials or other payer/regulatory opportunities. The Denial Prevention Manager fosters effective communications among the division, hospitals, and all ... Want to join a team of daring managers who care without reservations or limits? Our HealthOne team is...escalations to identify resolutions for policies or procedures impacting denials . Assesses business office, revenue cycle and/or clinical… more
- Crouse Hospital (Syracuse, NY)
- …utilization of resources, balanced with the patient's right to self-determination. The Manager of Care Coordination is responsible for providing day to ... Care Coordination is a collaborative practice model including...Areas of authority include Utilization Management, Discharge Planning and Denials and Appeals functions. General operational oversight including hiring… more
- Scottish Rite for Children (Dallas, TX)
- …to giving children back their childhood! Job Posting Title: Revenue Integrity Manager Location: Dallas - Hospital Additional Posting Details: Monday - Friday 8 ... will perform audits and reviews of departmental charge capture and reconciliation, denials management for all campuses, daily reporting and coordinated work on… more
- Geisinger (Danville, PA)
- Job Summary The Acute Care Manager for Geisinger at Home works with physician and multidisciplinary team members to develop plan of care for each assigned ... Ensure patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and evaluations. Assess and respond to patient and… more
- AdventHealth (Tavares, FL)
- …. The Social Work Care Manager ensures efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The ... **1000 WATERMAN WAY, Tavares, 32778** **The role you'll contribute:** The Social Work Care Manager intervenes with patients who have complex psychosocial needs,… more
- Covenant Health Inc. (Knoxville, TN)
- …and training for the coding staff. Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff ... serves as the user advocate between Health Information Management (HIM), Clinical Effectiveness, and Registration. Other job duties include: improving health record… more