- Glens Falls Hospital (Glens Falls, NY)
- …week, can be foundhere. **Job:** **Allied Health - Health Information Management* **Title:** * Coding Reimbursement Appeals Supervisor - Health ... Director, is responsible for compliant, complete and optimal facility coding , and in collaboration with Coding leadership...and DRG's that include all MCC's and CC's for reimbursement . In collaboration with Hospital External Review Team (HERT)… more
- Trinity Health (Farmington Hills, MI)
- …from expected reimbursement , and resolving or escalating issues to the Supervisor Payment Resolution for resolution. This position reports directly to the ... Supervisor Payment Resolution. **ESSENTIAL FUNCTIONS** Knows, understands, incorporates, and...of the payment resolution team that receives, analyzes, and appeals denials received for an assigned PBS location. Reviews,… more
- Trinity Health (Farmington Hills, MI)
- …received on denied accounts, and resolving or escalating issues to the Supervisor Payment Resolution Supervisor for resolution. Provides training and guidance ... problems as needed. This position reports directly to the Supervisor Payment Resolution. **ESSENTIAL FUNCTIONS** Knows, understands, incorporates, and demonstrates… more
- TEKsystems (Plano, TX)
- …resolve issues on accounts. Including but, not limited to Managed Care, Reimbursement , Clinical, Admissions, Facility Business Office Manager, Coding , Case ... Required: + 2+ years of Insurance follow-up, denials/ appeals experience (Medical A/R) + Hospital/facility collections experience Description: Responsible for A/R,… more
- Covenant Health Inc. (Knoxville, TN)
- …Registration and Business Office personnel to resolve issues related to claims, coding , pre-cert, and denials appeals , and verifies that appropriate chargemaster ... physician orders. + Attends meetings and provides input as it relates to coding , medical documentation, and reimbursement issues specific to medical billing and… more
- Beth Israel Lahey Health (Burlington, MA)
- …9. Keeps abreast of all government, managed care and third party hospital coding , billing and reimbursement rules, regulations and guidelines. 10. Promotes ... supervisor with the resolution of claims issues, denials, appeals and credits. 17. Works with the cash team...and Excel spreadsheets. Working knowledge of third party payer reimbursement , coding guidelines, and government and payer… more
- Houston Methodist (Houston, TX)
- …appropriate billing functions, including claims resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for any ... medical necessity or coding related appeals . **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Stays current on collection procedures of various payors and industry… more
- Beth Israel Lahey Health (Burlington, MA)
- …computer systems and Excel spreadsheets. Working knowledge of third party payer reimbursement , coding guidelines, and government and payer compliance rules ... for any opportunity to correct, refile and or appeal claims for re-processing and reimbursement . The role also includes review and rework of all types of denials, as… more
- Guthrie (Sayre, PA)
- …management to develop and train internal rejection protocols. Keeps current with coding knowledge, reimbursement policies, payer guidelines and other sources in ... Billing Specialists I and related support staff. Works closely with Director, Manager, Supervisor and Application Analyst on day to day priorities and to maintain a… more
- WellSpan Health (York, PA)
- …account follow-up, researches claim denial for resolution and submits disputes and appeals . Represents the System in a professional manner while interacting with ... bills, etc.- Resolves Claim edits to facilitate timely billing and reimbursement .- Performs follow-up with insurance companies to obtain claim status, payment… more
- Johns Hopkins University (Middle River, MD)
- …(medical reports, authorizations, etc.) as needed and submits to third-party payers. + Appeals rejected claims and claims with low reimbursement . + Performs ... escalates non-standard appeals to a higher-level specialist. + Informs the supervisor / Production Unit Manager of issues or problems associated with non-payment… more
- Johns Hopkins University (Baltimore, MD)
- …(medical reports, authorizations, etc) as needed and submits to third-party payers. + Appeals rejected claims and claims with low reimbursement . + Confirm credit ... for the collection of unpaid third-party claims and resolution of non-standard appeals , using various JHM applications and JHU/ PBS billing applications. Will… more
- Johns Hopkins University (Middle River, MD)
- …(medical reports, authorizations, etc) as needed and submits to third-party payers. + Appeals reflected claims and claims with low reimbursement . + Confirm ... responsible for the collection of unpaid third-party claims and appeals , using various applications of JHM and JHU/ PBS...follow-up processing and be knowledgeable in CPT and diagnosis coding as well as understand the JHOC registration process… more
- Weill Cornell Medical College (New York, NY)
- …claim status and billing guidelines to substantiate corrected claim submissions, written appeals , coding and medical necessity reviews. + Researches and ... for Medicare & Medicaid Services (CMS) & other third party payers, reimbursement & coding regulations including the institutional and department's compliance… more
- Universal Health Services (Riverside, CA)
- …of management, formally, or informally, either verbally or in writing). 1. Assist the supervisor as requested. 2. Review, adjust and or mail out all assigned tracer ... claims 3. Initiate claims review or appeals , as indicated on assigned explanation of benefits. 4....Review Explanation of Medical benefits to verify accuracy of reimbursement . C. Verify insurance coverage D. Initiate necessary account… more
- AdventHealth (Altamonte Springs, FL)
- …and all measures to resolve assigned accounts, including escalation to supervisor /manager if necessary. Processes administrative and medical appeals , refunds, ... deadlines. Examines contracts, and learns payer contracts to understand reimbursement methodology to appropriately reconcile patient accounts. Resolves and resubmits… more
- Universal Health Services (Tredyffrin, PA)
- …established performance targets (productivity and quality). Initiates and follows-up on appeals . Exercises good judgement in escalating identified denial trends or ... and reprocesses claims for payment in a timely manner. Proceeds with appeals process as needed. Performs eligibility and claim status follow-up inquiries utilizing… more
- e CancerCare (Nashville, TN)
- …Work an average of 40 to 80 denials per day based on supervisor requirements and accounts assigned. Works closely with insurance carriers for reimbursement ... timely payment Reviews outstanding AR accounts and contacts insurance for reimbursement explanation. Provides clear and accurate documentation of all contacts with… more
- Elderwood (Wheatfield, NY)
- …with Medicare experience? Do you consider yourself an expert in assessment and reimbursement methodology? We want to talk with you! RN - MDS Coordinator Position ... Medicare required assessments setting the completion date to maximize reimbursement and RUGs categories for each individual assessment. +...for pre and post-pay record reviews, ADR requests and appeals processes. + Manages NYS RUGs III case mix… more
- Elderwood (Amherst, NY)
- …(RN) with Medicare experience? Do you consider yourself knowledgable in assessment and reimbursement methodology? We want to talk with you! Elderwood at Amherst is ... Medicare required assessments setting the completion date to maximize reimbursement and RUGs categories for each individual assessment. +...for pre and post-pay record reviews, ADR requests and appeals processes. + Manages NYS RUGs III case mix… more