- Trinity Health (Farmington Hills, MI)
- …clinical expertise and clinical judgment within the Hospital and/or Medical Group revenue operations ($3-5B NPR) of a Patient Business Services (PBS) center. Serves ... Responsible for leveraging clinical knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing… more
- Trinity Health (Farmington Hills, MI)
- …day-to- day payment resolution activities within the Hospital and/or Medical Group revenue operations ($3-5B NPR) for an assigned Patient Business Services (PBS) ... as part of the payment resolution team that receives, analyzes, and appeals denials received for an assigned PBS location. Reviews, researches and resolves… more
- Providence (Portland, OR)
- …best people, we must empower them._** **Providence Health Plan is calling an Associate Utilization Review Specialist who will:** + Be responsible for all core ... Concurrent Review (CCR) + SNF + Clinical Claims + Provider Reconsideration + Member Appeals + Medical + Coding + Reimbursement Policy + Coordinate and execute the… more
- Robert Half Finance & Accounting (Austin, TX)
- …information - Collaboration/coordination with Utilization Review - Cross-training in Utilization Review - Appeals for denied claims and front/back-end ... responsibilities - Manage high volume telephone calls for prior authorizations, appeals , and updates - Research information for referral submissions and updates… more
- St. Luke's University Health Network (Allentown, PA)
- …+ Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and impact on revenue and trending. + Coordinates ... ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for...eg no appeal, appeal level and final decision with revenue impact. + Assists Case Management as necessary to… 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 support ... to ensure timely processing of all episodes of care. Reviews documentation for appeals processes across the Home Health enterprise for all payor types striving to… more
- Banner Health (AZ)
- …Arizona, Arizona **Department Name:** Denial Recovery-Corp **Work Shift:** Day **Job Category:** Revenue Cycle Nursing careers are better at Banner Health. We are ... your abilities - apply today. The Registered Nurse RN Denial Management Specialist is responsible for reviewing concurrent inpatient denials from the insurance… more
- Enterprise Mobility (St. Louis, MO)
- …opening of a new position within the Corporate Benefits Department - **Benefits Specialist ** ! The Benefits Specialist assists with the oversight and ... million vehicles and accounted for nearly $35 billion in revenue through a network of more than 10,000 fully-staffed...and local regulations and best practices + Manage administrative appeals + Ensure RFPs, contract terms and requirements are… more
- Sharp HealthCare (San Diego, CA)
- …responsible for reviewing all denial material and ensuring accurate second level appeals are filed for denied claims. **Required Qualifications** + 4 Years ... regulations of affiliated payors through coordination with Contract Reimbursement Specialist .Centralizing and reviewing all denial material (correspondence, EOBs, zero… more
- State of Colorado (Denver, CO)
- …and technical financial analyses, including cost estimations, expense and revenue projections, cash flow analyses, risk analyses, cost-benefit analyses, variance ... required reports on funds (including fund transfer calculations), progress reports, revenue and expense forecasts, variance reports, and any other requested… more
- Robert Half Accountemps (Sacramento, CA)
- …large hospital system is in need of a Medical Collector/Insurance follow-up specialist . The Medical Collector/Insurance follow-up specialist will be directly ... * 2-3 years of hospital insurance follow up, including utilization of phone calls and online payer portals *...2 years experience in medical billing or within the revenue cycle - High school diploma or equivalent required… more
- St. Luke's University Health Network (Allentown, PA)
- …will be made after review of supporting documentation, CCI/LCD, carrier policy and utilization of coding software applications. The appeals process may include ... collaboration with the Claim Editing Manager, Physician, Specialty Coder, AR specialist or Auditor/Educator. Demonstrate the ability to formulate an appeal rationale… more