- Experity (Atlanta, GA)
- …experience: from patients finding clinics and making appointments, to checking in, to clinical documentation, and to the final bill paid by the patient. Our team ... (CSM) and Supervisor Contact insurance companies regarding claim status, follow-up on denials or partial payments Analyze denied claims to find the root cause… more
- NavitsPartners (Worcester, MA)
- …and apply clinical pathways to streamline care Mitigate risks of denials by proactively reviewing case progress Comply with safety, regulatory, and quality ... Job Title: Travel RN - Case Management Specialist Location: Hyannis, MA Assignment Type: Travel Contract...admissions and escalate concerns per protocol Handle payer communication, appeals , and notifications such as HINN Coordinate services for… more
- Biodesix, Inc. (Louisville, CO)
- …and submit claims and appeals to insurance on behalf of patients. Billing Specialist I will work closely with Client Services and Billing Team to ensure accurate ... Year of Medical Billing experience required, including knowledge of claims processing, denials , and appeals . 1-3 Years of Medical/Laboratory experience preferred… more
- NewVista Behavioral Health (Cincinnati, OH)
- Job Address: 10123 Alliance Road, Suite 340Blue Ash, OH 45242 Accounts Receivable Specialist In conjunction with some of the areas most advanced physicians and ... clinical teams, Lynx EMS offers high quality medical transport...join an outstanding team! The Role The Accounts Receivable Specialist is responsible for overseeing the billing of all… more
- University of Michigan (Ann Arbor, MI)
- Denials Prevention/ Appeals Specialist Apply Now **Job Summary** The Denials Prevention and Appeals Specialist is responsible for ensuring the ... employment opportunity employer. **Job Detail** **Job Opening ID** 266022 **Working Title** Denials Prevention/ Appeals Specialist **Job Title** Medical Coder… more
- Hartford HealthCare (Farmington, CT)
- …of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials , ... **Job:** **Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 2 / HIM Coding* **Location:**… more
- HCA Healthcare (Dallas, TX)
- …**_Note: Eligibility for benefits may vary by location._** We are seeking a Clinical Denials Coding Review Specialist for our team to ... as we do. We want you to apply! **Job Summary and Qualifications** Seeking a Clinical Denials Coding Review Specialist , who is responsible for applying… more
- Houston Methodist (Houston, TX)
- …staff; and functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** + Communicates openly in a ... At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating... is responsible for coordinating and monitoring the coding-specific clinical charges and denial management and appeals … 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 ,...TRAINING AND EXPERIENCE: + Minimum of 2-5 years of clinical nursing experience in an acute care hospital setting… more
- HCA Healthcare (Nashville, TN)
- …and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts ... you want to join an organization that invests in you as an Inpatient Coding Denials Specialist ? At Parallon, you come first. HCA Healthcare has committed up to… more
- PeaceHealth (Vancouver, WA)
- **Description** PeaceHealth is seeking a Coding Denials Specialist . This position is remote but does require the associate to live / work in OR, WA, AK or TX to ... be eligible for consideration. **Job Summary** Coding Denials Specialist analyzes, processes, and resolves claim...correspondence work queues for new correspondence related to DRG denials . + Routes clinical denials … more
- St. Luke's University Health Network (Allentown, PA)
- …serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, ... needed for workflow or identification of trends. Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and… more
- St. Luke's Health System (Twin Falls, ID)
- …You Can Expect:** Under limited supervision, the Clinical Appeals Specialist , is responsible for managing client medical denials by conducting a ... sources to provide and maintain a single reporting location that reflects clinical denials and appeals activity. + Recommends improvements and modifications… more
- Robert Half Accountemps (Los Angeles, CA)
- …A Medical IPA Group in Los Angeles is in the immediate need of a Grievance & Appeals Specialist . The Grievance & Appeals Specialist , will be in ... with State/Federal laws, rules, and guidelines. The Grievance & Appeals Specialist will be expected to perform...provisions. * Write determination letters regarding the outcome of non- clinical reviews/claim denials and send to the… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... or AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and… more
- Elevance Health (Irving, TX)
- …our specialty pharmacies, our infusion centers, and the home setting._ **Referral Specialist II/Patient Access (Pre & Prior Authorizations, Appeals , Insurance) - ... weeks/30 days at the Plano, TX office. The **Referral Specialist II** is responsible for providing support to a...necessary. + Ability to initiate pre-determination, prior authorizations, and appeals for denials based on payer policy.… more
- Cardinal Health (Fresno, CA)
- …HCPCS coding to support appropriate reimbursement and reduce denial rates. The specialist collaborates closely with billing, coding, clinical teams, and payers ... Revenue Cycle Management manages a team focused on a series of clinical and administrative processes that healthcare providers utilize to capture, bill, and… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve ... and off-label drug authorizations. The Clinical Authorization Specialist is also responsible for managing denials ...Creates cost estimates for waivers. + Root causes claim denials , reprocesses, and submits claim appeals . +… more
- Dana-Farber Cancer Institute (Brookline, MA)
- The Cell Therapy Clinical Authorization Specialist is responsible for the comprehensive coordination and management of all prior authorization activities ... (CAR) T-cell therapy, and other immune effector cell treatments. The Specialist works autonomously to secure initial and ongoing authorizations, monitor… more
- Independent Health (Buffalo, NY)
- …coding guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records, consultation with ... and a culture that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding… more
