- 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
- 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 ... day-to- day payment resolution activities within the Hospital and/or Medical Group revenue operations ($3-5B NPR) of an assigned Patient Business Services (PBS)… more
- University of Michigan (Ann Arbor, MI)
- …Inpatient Coding and Appeals Coordinator plays a vital role in the revenue cycle management of Rev Cycle Mid-Service by maintaining the financial integrity of ... employer. **Job Detail** **Job Opening ID** 248438 **Working Title** Inpatient Coding and Appeals Coordinator - Remote **Job Title** Utilization Rev Appeals … 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
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that assure ... determinations - OBS vs. Inpatient c. Liaison to the Medical Staff supporting Utilization Management Committee processes d. Hospital Based Appeals Management e.… more
- Hackensack Meridian Health (Hackensack, NJ)
- …transform healthcare and serve as a leader of positive change. The **Appeal Nurse Specialist ** will be responsible for the timely review and submission of appeals ... level of care change determinations. Gathers and evaluates the information for appeals of Managed Care audits, clinical and technical denials by utilizing various… 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
- Fairview Health Services (St. Paul, MN)
- …steps such as peer-to-peer reviews and appeals in conjunction with revenue cycle, care teams, utilization review, and patients/guarantors. + Maintain ... **Overview** This is a remote position under Revenue Cycle Management that is responsible for obtaining...or enablement of collecting expected payment. + Understand/adhere to Revenue Cycle's Escalation Policy and work collaboratively to achieve… 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