- Randstad US (Dallas, TX)
- medical appeals and denials specialist . + dallas , texas + posted february 2, 2024 **job details** summary + $20 - $20.93 per hour + temp to perm + high ... Modifiers .Knowledge of Payor filing and appeal deadlines. .Ability to research denials .Ability to compose and file appeals /reconsiderations .Managed care,… more
- Beth Israel Lahey Health (Charlestown, MA)
- …Type:** Regular **Scheduled Hours:** 40 **Work Shift:** Day (United States of America) **The Denials Specialist role is eligible for a $1,500 sign on bonus.** ... 7-3:30PM) with a comprehensive benefit program.* **Job Description:** The Denials Specialist position is a key role...denials with a focus on reviewing and interpreting denials and facilitating first and second level appeals… more
- TEKsystems (Plano, TX)
- Required: + 2+ years of Insurance follow-up, denials / appeals experience (Medical A/R) + Hospital/facility collections experience Description: Responsible for ... Responsible for managing CBO Aging Report properly to insure appeals are followed up timely to prevent past filing...Responsible for timely medical records requests and submission of appeals * Maintain adequately trained staff to achieve daily… more
- Trinity Health (Farmington Hills, MI)
- …Payment Resolution with communication and follow-up processes related to rejections, denials and appeals , ensuring that such activities are tracked, ... Work Remote Position (Pay Range: $34.9314-$52.3971) Responsible for reviewing all post-billed denials (inclusive of clinical denials ) for medical necessity and… more
- Trinity Health (Farmington Hills, MI)
- …activities as part of the payment resolution team that receives, analyzes, and appeals denials received for an assigned PBS location. Reviews, researches and ... Business Services (PBS) location. The scope of responsibility will be all post-billed denials (inclusive of clinical denials ). Serves as part of the Payment… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding specific clinical charges and denial ... functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** +...Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved Specialty Society Coding… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... and rejections. + Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and impact on revenue and trending. +… more
- Insight Global (Nashville, TN)
- Job Description Job Purpose: The Denials Specialist generates revenue by monitoring and pursuing payment on all unpaid and delinquent denied claims; serving as a ... timely claim submission and payment Work average of 30-50 denials per day based on supervisor requirements and accounts...importance and relationship to patient care Initiate and complete appeals for disputed / denied claims. Works / Understands… more
- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** The Supervisor of Denials -PFS is responsible for reviewing all denial material and ensuring accurate second ... level appeals are filed for denied claims. **Required Qualifications** +...regulations of affiliated payors through coordination with Contract Reimbursement Specialist .Centralizing and reviewing all denial material (correspondence, EOBs, zero… more
- SSM Health (Jefferson City, MO)
- …**Job Highlights:** We are seeking a highly skilled and detail-oriented Coder for Hospital Denials to join our team at SSM Health. You will be responsible for ... reviewing medical records and accurately coding diagnoses and procedures for hospital denials . This role requires strong analytical skills, attention to detail, and… more
- Universal Health Services (Bonham, TX)
- …is managed by Texoma Medical Center, subsidiary of UHS. The Appeals Specialist is responsible for appealing all insurance denials and prepare relevant ... in compliance with Managed Care contracts and government fee schedules. The Appeals Specialist will obtain, manipulate, and analyze data from a variety of… more
- Molina Healthcare (Milwaukee, WI)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers... appeals and denials . + Strong verbal and written communication skills To… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES & ESSENTIAL JOB...Management team when cases do not meet criteria; coordinates denials with the attending physician and the Care Management… more
- St. Luke's University Health Network (Allentown, PA)
- …clean claim submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across the network. Utilizes ... coding errors and MUE frequency for clean claim submission + Resolve coding denials through claim correction or appeal. Claim corrections will be made after review… more
- Randstad US (Columbus, OH)
- …job details Our client, a large health care company, is looking for a Grievance and Appeals Specialist in the Columbus, OH area to support a Hybrid Role. Please ... AM - 5 PM education: High School Responsibilities Pulling appeals from the workbasket, reviewing claim denials ,...Pulling appeals from the workbasket, reviewing claim denials , setting up cases for nurse reviews, sending out… more
- Houston Methodist (Houston, TX)
- …This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the ... At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect...queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits… more
- Hartford HealthCare (Farmington, CT)
- …and homecare to insure optimal revenue cycle performance. The AR Follow Up & Denials Specialist is responsible for resolving unpaid third party balances on $550 ... million in active inventory and $70 million in denials through account follow up, appeals and resubmission actions. This position reports directly to the AR… more
- Carle (Urbana, IL)
- … denials to reduce losses; works and appropriately appeals the denials from insurance companies. The Cancer Services Specialist coordinates all cancer ... Cancer Services Specialist (Carle Cancer Institute) + Department: Cancer Institute...and accurate manner to ensure appropriate reimbursement and claims appeals Makes appropriate independent decisions that may have a… more
- Beth Israel Lahey Health (Burlington, MA)
- …of America) Identifies, reviews, and interprets third party payments, adjustments and denials . Initiates corrected claims, appeals and analyzes unresolved third ... Assists the Billing Supervisor with the resolution of complex claims issues, denials , appeals and credits. 17. Works with cash team to resolve unapplied cash.… more
- Beth Israel Lahey Health (Charlestown, MA)
- …of America) Identifies, reviews, and interprets third party payments, adjustments and denials . Initiates corrected claims, appeals and analyzes unresolved third ... Assists the Billing Supervisor with the resolution of complex claims issues, denials , appeals and credits. 17) Works with cash team to resolve unapplied cash.… more