- Surgery Partners (Addison, TX)
- GENERAL SUMMARY OF DUTIES: The primary responsibility of the Medical Collection Specialist is to ensure effective collection of all patient accounts. This is a ... work assigned independently and multi-task Knowledge of insurance, billing terms, CPT/ICD10, coding and DRG Knowledge of modifiers usage and CCI edits Strong medical… more
- Patient Financial Concepts, Inc (Thomaston, GA)
- …Verify patient eligibility, resolve insurance denials, and submit secondary claims/ appeals as needed. Address deductible, co-insurance, and co-pay questions and ... recommend coding changes. Perform soft collections and scrub Aged Trial Balance Reports for insurance discrepancies. Train team members and assist with internal… more
- UHS (Wayne, PA)
- …- Independence Physician Management - UHS. Position Overview The Accounts Receivable Specialist is responsible for the accurate and timely follow-up of unpaid and ... established performance targets (productivity and quality). Initiates and follows-up on appeals . Exercises good judgement in escalating identified denial trends or… more
- Cencora (New York, NY)
- …billing with miscellaneous J-code), formulary, benefit investigations, prior authorization, coding , and appeals processes Deep understanding of medical ... with understanding the payers' coverage management strategies for product, including coding , billing, formulary, prior authorization, and appeal processes. Probe to… more
- Greenberg Traurig LLP (Denver, CO)
- …within an innovative and collaborative environment. Join our team as a Legal Support Specialist located in our Denver office. We are seeking a highly skilled Legal ... Support Specialist who thrives in a fast-paced, deadline-driven environment. The...deposition and court transcripts and creating and using substantive coding tools Assists with trial preparation, including creating trial… 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 retrospectively reviews patient medical records, claims ... or AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support… 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
- 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 accuracy ... and integrity of coding and billing processes within Michigan Medicine. This position...**Job Detail** **Job Opening ID** 266022 **Working Title** Denials Prevention/ Appeals Specialist **Job Title** Medical Coder Compliance… 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
- TEKsystems (Tampa, FL)
- …accurate and timely review, processing and payment of bills to include pre- coding accuracy and adjudication of appeals /provider reconsideration requests. * ... itemized billings for excessive charges, duplications, and appropriate medical bills coding * Reviews/processes appeals and initiates refund requests, assists… 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. + Ability… more
- St. Luke's Health System (Twin Falls, ID)
- …place to work. **What You Can Expect:** Under limited supervision, the Clinical Appeals Specialist , is responsible for managing client medical denials by ... as necessary. + Acts as a resource to the verifiers on documentation, coding & clinical account review. + Maintains knowledge of state and federal guidelines,… 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
- Houston Methodist (Houston, TX)
- …& Denials Specialist is responsible for coordinating and monitoring the coding -specific clinical charges and denial management and appeals process in a ... and functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS**...one of the following: + * CCS - Certified Coding Specialist (AHIMA) + * CPC -… more
- Independent Health (Buffalo, NY)
- …a culture that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding ... They will aid in training other team members, evaluating appeals , and share audit trends across the team. Expertise...and audit tips across the team. The Clinical & Coding Specialist -Senior will support the leadership in… 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 ... 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 $300… more
- Molina Healthcare (Houston, TX)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals… 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 ... have three openings - at the Springbrook location in Seattle._ The Professional Coding Education Specialist will support activities related to educating billing… 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 ensure that we continue to ... We want you to apply! **Job Summary and Qualifications** Seeking a Clinical Denials Coding Review Specialist , who is responsible for applying correct coding … 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
