- 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 ... a concise appeal letter, including appropriate medical records submission. + Performs timely review of medical records and remittances for denials in order to… more
- Trinity Health (Farmington Hills, MI)
- …data, draws conclusions, and reviews findings with all levels of Payment Resolution Specialist for further review . Serve as a resource to Payment Resolution ... 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
- University of Colorado (Aurora, CO)
- Clinical Utilization Review Specialist - 32339 University Staff **Description** **University of Colorado Anschutz Medical Campus** **School of Medicine | ... Department of Psychiatry** **Job Title: Clinical Utilization Review Specialist ** **Position: #00217340 - Requisition: #32339**...of discussion and appeal letters for Medicaid medical necessity denials . + Review , process and audit the… more
- Sutter Health (Berkeley, CA)
- …trend timely appeal/denial data, following up with appropriate staff/departments. + Conduct retrospective and current chart review to validate documentation when ... format. May perform trending and create summary reports. + Review medical records documentation in response to denials... Review medical records documentation in response to denials or authorizations for level of care issues and… more
- Alameda Health System (San Leandro, CA)
- … functions, including response to payor requests for concurrent and retrospective review information including Medicare and MediCal regulations/requirements; ... Care Management Clinical Appeals Specialist + San Leandro, CA + Finance +...Management team when cases do not meet criteria; coordinates denials with the attending physician and the Care Management… more
- Tufts Medicine (Burlington, MA)
- …is discharged except weekends and company-approved holidays. 3. Performs retrospective review of discharged encounters, accurately identifies discrepancies ... Integrity (CDI) Specialist III is responsible for concurrent and retrospect review and analysis of the medical record to improve overall quality and completeness… more
- Fairview Health Services (St. Paul, MN)
- …Coding Documentation Liaisons on the Quality and Education Team perform retrospective and prospective Quality Assurance Checks and provide tailored education to ... Line/Domain leaders, providers, coding leaders/staff, compliance, Informatics, Revenue Integrity, Denials , and other key stakeholders to improve the quality of… more