- University Medical Center of El Paso (El Paso, TX)
- Job Description: The Denials and Appeals Specialist follows up on denied claims from commercial and contracted payers. Performs timely and appropriate ... review, managed care, and/or claims denials and appeals processing required. License/Registration/Certification: Certified Clinical Documentation Specialist … more
- Accounting Now (Tampa, FL)
- Medicare Appeals Specialist Do you like challenging payers? Enjoy that feeling of satisfaction when your appeal is overturned? Then, this position may is right ... you! The ideal candidate will be well versed in the Medicare managed care appeals and grievance process. Must have strong knowledge of Medicare payer guidelines and… more
- Accounting Now (Tampa, FL)
- The Denials Specialist performs advanced-level work related to clinical and coding denial management and appeals follow-up. The individual is responsible for ... This position anticipates and responds to a wide variety of issues/concerns. The Denials Specialist works independently to plan, schedule and organize activities… more
- Option Care Health (Phoenix, OR)
- …payments. Assists with Billing and Collection Training and completes "second level" appeals to payers.Hours: as early as 6am -8am PSTJob Description: Job ... frame. Generates and mails statements and collections letters. Follows-up on all denials within 48 hours of receipt.Ensures compliance with policies and guidelines… more
- Creative Financial Staffing (Fresno, CA)
- …to patient accounts accurately and efficiently. Investigate and resolve claim denials , including appeals and resubmissions. Maintain thorough and accurate ... Billing Specialist Overview of the Billing Specialist : Our client is a reputable and well-known healthcare company in Fresno New office space Friendly work… more
- Accounting Now (Pinellas Park, FL)
- …in St Petersburg, Florida:Medical Collector The medical billing and collection specialist is responsible for ensuring accurate billing, timely submission of ... and/or paper claims, monitoring claim status, researching rejections and denials , documenting related account activities, posting adjustments and collections of… more
- 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
- Trinity Health (Farmington Hills, MI)
- …Maintains knowledge of state/federal laws as they relate to contracts and the appeals process. Assists in training Payment Resolution Specialist I colleagues ... location. The scope of responsibility will be all post-billed denials (inclusive of clinical denials ). Serves as...as to ensure timely follow-up and action for account appeals . + Works with Patient Access and other necessary… 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
- 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
