- Southeast Georgia Health System (Brunswick, GA)
- …process in a timely manner. Demonstrates proficiency in preparation and follow-up of denial appeals . Maintains denial spreadsheet report-keeps it current & ... the key to our culture of Service Excellence. As a Resource Management Coordinator , you will conduct medical record reviews of all denied inpatient and/or… more
- Howard University Hospital (Washington, DC)
- …groundbreaking research and positive patient outcomes. Howard University Hospital seeks to hire an Denial and Appeals Coordinator who will embrace our reach ... with a team of professionals who are doing just that, making a difference. The Denial and Appeals Coordinator : The Denial & Appeals Coordinator … more
- CVS Health (Fresno, CA)
- …between 9am-1pm. Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may ... responses from multiple business units. Ensure timely, customer focused response to appeals . Identify trends and emerging issues and report and recommend solutions.… more
- UCLA Health (Los Angeles, CA)
- …for accuracy, confirming the receipt of necessary documentation to support the denial and ensuring compliance with all contractual obligations and state and federal ... with them for clinical guidance in resolving cases. You will also document appeals in the tracking system and maintain relevant statistical data. Salary Range:… more
- Penn Medicine (Philadelphia, PA)
- …Confidentiality, and continuity of communication. + Supports the activities of the Clinical Appeals Coordinator in all phases of the Clinical Quality and ... of patient related information including the hospital database, reports and all denial and appeals correspondence. + Maintains database for the department… more
- Hartford HealthCare (Southington, CT)
- …of Connecticut's most comprehensive healthcare network as a Quality Improvement Coordinator . Hartford HealthCare at Home, the largest provider of homecare services ... clients and their clients' families. Basic Purpose of the Position: **Manages appeals at the branch level including clinical documentation review, training, and… more
- Rush University Medical Center (Chicago, IL)
- …* Provides designated support for functions including payer approval / certification communication, denial appeals , and / or level of care management processes. ... 0.5) **Shift:** **Shift 1** **Work Schedule:** 8 Hr The Clinical resource coordinator (CRC) applies a collaborative approach in working with physicians, patients,… more
- Athena Health Care Systems (Seymour, CT)
- Resident Care Coordinator Assistant 7 am - 3 pm, Full-Time Shady Knoll Health Center - Seymour, CT Posted 1 week ago We are hiring a Resident Care Coordinator ... to grow within the company. As a Resident Care Coordinator Assistant, you will assist the Resident Care ...certifications and recertification. + Mails and tracks all Medicare denial letters. + Retrieves/prints and faxes medical records to… more
- Universal Health Services (Doylestown, PA)
- …Facilitates and fully documents physician peer-to-peer reviews, and prepares and submits written appeals in response to denial of initial or continued stay ... Responsibilities Foundations Behavioral Health is currently hiring a full-time Utilization Review Coordinator to support our UM Department in Doylestown, PA. This is… more
- BrightSpring Health Services (Columbus, OH)
- …Payee to Client Trust Fund* Responsible for working with Client Trust Fund Coordinator at the Austin* Business Center to set up RFMS Account* Assure individuals ... for each individual annually or as needed* Files Medicaid Appeals when required within 30-day time frame of decisions*...billing is complete for upload into Quickbase. Sends monthly Denial Reports to operations for any billing denied by… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient ... of potential denials and respond appropriately; ie facilitate Physician to Physician appeals when appropriate and assist with construction of appeal letters. +… more
- CVS Health (Orlando, FL)
- …setting at our Patient Financial Service Centers, supporting the claims follow up, denial and appeals processes. You will directly impact a patient's life ... solutions to make health care more personal, convenient and affordable. Position Summary As a Coordinator , Revenue Cycle, you will work in a pharmacy operation… more
- Universal Health Services (Madera, CA)
- …currently seeking a forward thinking and compassionate UTILIZATION MANAGEMENT(UM) COORDINATOR . Facilitates a continuum of service while promoting positive outcome ... coordination of patient care, daily clinical reviews, quality documentation, appeals , and reporting. QUALIFICATIONS Education: Bachelor's degree in Nursing,… more
- Highmark Health (Harrisburg, PA)
- …requirements. + Documents, monitors, intervenes/resolves and reports clinical denials/ appeals and retrospective payer audit denials. Collaboratively formulates plans ... of action for denial trends with the care coordination teams, performance improvement teams, physicians/physician advisor and third party payers. + Maintains a… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …infusion center to prevent denials. Assists UM Coordinator with denials and appeals . Close out each tracked denial (overturned or recouped). Overall works to ... Office personnel, etc. to obtain appropriate information related to the reimbursement/ denial process. + Physical + Normal hospital business office environment.… more
- State of Colorado (Denver, CO)
- …knowledge of treatment process capabilities, reviews and recommends approval or denial of site location applications. Reviews for conformance with design criteria ... and applicable regulations/statutes and issues approval or denial for wastewater and drinking water treatment and conveyance...this position, please direct your inquiries to our ADAAA Coordinator at ###@state.co.us or call ###, option 5. APPEAL… more
- University of Utah (Salt Lake City, UT)
- …and payer processes related to coding policy, medical necessity, denials and appeals . 10. Research and evaluate coding, documentation practices, and processes, and ... through data analysis or chart review. 11. Responsible for denial prevention, recommendations, and communications through resolution. 12. Research...cycle expertise with a focus on coding denials and appeals + Experience with CPT and CMS ICD -10… more
- Nuclear Regulatory Commission (Atlanta, GA)
- …exam results and recommends operator license issuance or denial . Evaluates license denial issues of other examiners during applicant appeals and hearings. 4. ... where appropriate. Individuals with disabilities may contact the Selective Placement Coordinator for assistance with the application or hiring process via… more
- St. Luke's University Health Network (Allentown, PA)
- …entry staff for single or low volume errors. Report high volume coding denial trends to the coordinator + Maintain meticulous documentation, spreadsheets, ... ability to pay for health care. The Claim and Denial Coding Analyst role is a Certified Medical Coder...carrier policy and utilization of coding software applications. The appeals process may include collaboration with the Claim Editing… more
- University of Rochester (Rochester, NY)
- …in multiple systems including eRecord and OTTR. + Assist RN and APP coordinator in ensuring that the program has the most up-to-date clinical and financial ... of the electronic medical record. Decides based on previous authorization approvals and denial experience, the relevant information to be included in the request. +… more
