- 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 ... payers to successfully clear front end claim edits, appeal clinical denials , and address customer service inquiries....Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved Specialty Society Coding… more
- Trinity Health (Farmington Hills, MI)
- …Patient Business Services (PBS) location. The scope of responsibility will be all post-billed denials (inclusive of clinical denials ). Serves as part of the ... as part of the payment resolution team that receives, analyzes, and appeals denials received for an assigned PBS location. Reviews, researches and resolves payment… more
- Trinity Health (Farmington Hills, MI)
- …Patient Business Services (PBS) location. The scope of responsibility will be all post-billed denials (inclusive of clinical denials ). Serves as part of a ... relate to contracts and the appeals process. Assists in training Payment Resolution Specialist I colleagues upon hire and as new systems and processes are created.… more
- TEKsystems (Plano, TX)
- Required: + 2+ years of Insurance follow-up, denials /appeals experience (Medical A/R) + Hospital/facility collections experience Description: Responsible for A/R, ... on accounts. Including but, not limited to Managed Care, Reimbursement, Clinical , Admissions, Facility Business Office Manager, Coding, Case Management, HIM and… 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
- Sharp HealthCare (San Diego, CA)
- …(correspondence, EOBs, zero payments on acct, etc., notes in IDX from clinical /financial staff).Working with Insurance Specialist to identify additional denial ... and employer business practices. **What You Will Do** The Supervisor of Denials -PFS is responsible for reviewing all denial material and ensuring accurate second… 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
- Texas Health Resources (Arlington, TX)
- …Professional Coder Upon Hire **REQUIRED** or CCS-P - Certified Coding Specialist - Physician-based Upon Hire **REQUIRED** and Other Specialty certification such ... Hire Preferred **Required Skills** . Advanced knowledge of procedural and clinical diagnosis coding pertaining to professional billing. . Knowledge of third-party… more
- Alameda Health System (San Leandro, CA)
- …made to discontinue the process; assumes the responsibility for coordinating and appealing clinical denials per department policy; develops any appeal letters to ... Care Management Clinical Appeals Specialist + San Leandro,...Management team when cases do not meet criteria; coordinates denials with the attending physician and the Care Management… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview The Clinical Coding and Audit Specialist monitors, responds and performs the clinical coding and audit ... across the Home Health enterprise for all payor types striving to improve clinical documentation and minimize lost revenue. Conducts analysis on timely submission of… more
- Tufts Medicine (Burlington, MA)
- …can't wait to grow alongside you. **Job Profile Summary** The role of the Clinical Documentation Integrity (CDI) Specialist III is responsible for concurrent and ... of the medical record to improve overall quality and completeness of clinical documentation. The CDS III facilitates and obtains appropriate modifications to … more
- Albany Medical Center (Albany, NY)
- …contract and works diligently toward the identification, mitigation, and prevention of clinical denials . In addition to contacting payers and providers via ... America) Salary Range: Min. $23.96/hr - Max $38.34/hr The Clinical Pre-Authorization Specialist will assist the Patient...ensure accuracy by Payer and Product line. + Reviews clinical denials including those related to pre-authorizations;… more
- MD Anderson Cancer Center (Houston, TX)
- **Summary** Analyzes medical records and abstracts clinical data by assigning codes from patient records in accordance to coding classification systems. Reviews ... data. **Key Functions** 1. Analyzes medical records to abstract clinical data by assigning codes from patient records in...9. Resolves claim and billing edits as well as denials by performing second review of medical record documentation… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is ... identified by the Revenue Cycle Managers. In addition, the Revenue Cycle Specialist is responsible for resolving all outstanding third-party primary and secondary… more
- Carle (Urbana, IL)
- RN - Clinical Transition Specialist + Department: IP Clinical Case Mgmt - CFH + Entity: Champaign-Urbana Service Area + Job Category: Nursing + Employment ... prior authorizations for swing bed patients, maintain the work ques, and address denials . + RMH: make follow up appointments with primary care provider before… more
- Hackensack Meridian Health (Hackensack, NJ)
- …determinations. Gathers and evaluates the information for appeals of Managed Care audits, clinical and technical denials by utilizing various Epic and legacy ... as a leader of positive change. The **Appeal Nurse Specialist ** will be responsible for the timely review and...at **Hackensack Meridian** **_Health_** includes: + Reviews all retroactive denials in the Epic work queues to assess and… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Clinical Documentation Integrity Specialist Full-Time, 80 Hours per pay period, Day Shift Covenant Health Overview: Covenant Health is East Tennessee's ... the appropriate assignment of a final DRG. The CDI Specialist functions as a resource for clinical ...Monitors activities and findings with regard to audits and denials and subsequently adjusts to potential trends when reported.… more
- Baptist Memorial (Jackson, MS)
- Summary The Accounts Receivable Follow Up Specialist performs all collection and follow up activities with third party payers to resolve all outstanding balances and ... receivable, percentage of accounts aged greater than 90 days, cash collections, and denials resolution in support of the team efforts in the achievement of accounts… more
- Penn Medicine (Philadelphia, PA)
- …Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- Robert Half Accountemps (Indianapolis, IN)
- …Medical Accounts Receivable Specialist . You'll be responsible for reviewing denials and rejections for clinical reasons, identifying trends, and offering ... M-F 8am-4:30pm. Additional responsibilities are listed below: + Review denials and rejections for clinical reasons +...below: + Review denials and rejections for clinical reasons + Identify trends and offer suggestions for… more