- PedIM Healthcare (Crystal River, FL)
- …Florida. We are currently seeking a detail-oriented and experienced Medical Billing Specialist to join our team. If you're passionate about healthcare finance, have ... Follow up on unpaid or denied claims and handle appeals as needed. Work with patients to address billing...is a plus. Proven experience as a Medical Billing Specialist in a healthcare setting. Strong knowledge of medical… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Coding Appeals Specialist analyzes patient medical records, claims data and ... MS-DRG for the purposes of appealing proposed MS-DRG and coding changes by insurance providers or their auditors. Assures...provide feedback, including identification of trends, to the Network Coding and CDMP Managers for education of the medical… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and ... formal meetings with auditor or payor representatives in defense of coding appeals , as needed. + Maintain necessary audit/appeal activity documents including… more
- McLaren Health Care (Mount Pleasant, MI)
- …ACDIS memberships + Certified Medical Coder, Certified in Healthcare Compliance, Certified Coding Specialist , or Certified Clinical Documentation Specialist ... . Provides support to both internal and external customers for denial/ appeals activities and audits. Assists with monitoring and auditing activities, reviews… more
- Community Health Systems (Franklin, TN)
- …and supports initiatives that improve denial prevention and recovery processes. As an Appeals Specialist II at Community Health Systems (CHS) - SSC Nashville, ... **Job Summary** The Appeal Specialist II reviews, analyzes, and resolves insurance denials...retractions or reimbursement impacts. + Monitors payer billing and coding updates and communicates changes to SSC and ancillary… more
- Mayo Clinic (Rochester, MN)
- …will have the following experience: Advanced knowledge of ICD-10-CM/PCS coding conventions, DRG reimbursement methodology, and clinical validation principles, with ... demonstrated ability to interpret Coding Clinic guidance and Medicare IPPS regulations to support...denials. Experience in utilization review, case management, denials and appeals , revenue cycle, or prior authorization preferred. Knowledge and… more
- Health Care Service Corporation (Tulsa, OK)
- …Is Responsible For Processing And Adjudicating Complex Non-Utilization. Management Appeals According To The Appropriate Federal, State, And Ncqa Requirements ... In Writing, To All Inquiries Involving Member*S Requests For Appeals . May Train And Mentor Less Experienced Appeals...medical environment. * Knowledge of medical terminology to include coding . * Experience and skills to analyze and assist… more
- Northwell Health (Melville, NY)
- …serves as a resource for the Health System. Reviews denial trends and identifies coding issues and knowledge gaps. Job Responsibility + Serves as liaison between the ... current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness… more
- Hartford HealthCare (Farmington, CT)
- …Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS),and/or Certified Clinical Documentation ... . Prepare, document, and submit appeals for DRG denials, ensuring appeals are well-supported with clinical evidence, coding guidelines, and regulatory… more
- University of Southern California (Alhambra, CA)
- …1 - 2 years Lead Experience. Required Licenses/Certifications: + Req AHIMA Certified Coding Specialist (CCS) only; or AAPC Certified Inpatient Coder (CIC) only; ... coding compliance regulations and guidelines, the HIM Coding Denials Management Specialist " analyze, investigate, mitigate,...need for appeal. Performs all 1st and 2nd level coding -related denial appeals . All tasks & duties… more
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials ... to ensure compliance. + Collaborate with clinical staff and coding teams to obtain necessary documentation for appeals... coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed… more
- Fairview Health Services (St. Paul, MN)
- …Info Admin or Registered Health Info Tech or Certified Inpatient Coder (CIC)or Certified Coding Specialist **Preferred Qualifications** + BS/BA in HIM + 1 year ... **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts...medical records and coding guidelines to formulate coding arguments for appeals and/or coding… more
- Fairview Health Services (St. Paul, MN)
- …in reading and interpreting commercial payer medical policies + Certified Coding Specialist -Professional (CCS-P) or + Certified Professional Coder (CPC) ... **Job Overview** The Physician Coding Denials Specialist performs appropriate efforts...medical records and coding guidelines to formulate coding arguments for appeals and/or coding… more
- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Coding Integrity Specialist will be responsible for executing a variety of activities ... involving the coding of medical records, resolving coding related...appeals . + 2+ years of experience as a coding auditor with proven accuracy and compliance. + Required… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …required; Associate degree preferred. + Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required. + Minimum ... to clarify documentation and ensure code accuracy. + Monitor and respond to coding -related denials, rejections, and edits; assist with appeals and identify areas… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **43114BR** **Extended Job Title:** Coding Specialist **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Review medical record ... documentation and coding guidelines. + Reviewing medical coding claim denials for correction and appeals ...medical coding claim denials for correction and appeals within the AthenaIDX and Enterprise Task Manager (ETM)… more
- Seattle Children's (Seattle, WA)
- …ensure coding and documentation compliance. **Required Credentials** Certified Coding Specialist -Physician Based (CCS-P) certification by the American Health ... creation of educational materials. Experience in revenue cycle functions, including coding denial management and appeals process. Experience in research… more
- University of Utah (Salt Lake City, UT)
- …Number** PRN43493B **Job Title** Medical Coders **Working Title** Medical Appeal & Coding Specialist **Career Progression Track** S00 **Track Level** S3 - ... + Reviews specialty work queues for trends for quality coding and account review and appropriate account resolution of...2 team members. + Monitor and resolve denials and appeals to ensure timely collection. + Maintain work queue… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …+ Education + High school graduate is required. Completion of medical terminology and coding classes in ICD-9-CM. + Experience + Requires minimum of two years in ... ICD-9-CM coding experience. Previous healthcare billing and follow-up experience preferred....Calling insurances to follow up on payment status or appeals due to denials or incorrect payments. Calling patients… more
- Hartford HealthCare (Farmington, CT)
- …. Prepare, document and submit appeals for DRG denials, ensuring appeals are well-supported with clinical evidence, coding guidelines, and regulatory ... and other common practices across the system. *_Position Summary:_* The Denial Specialist is responsible for reviewing, analyzing and appealing denials related to… more
