- MedStar Health (Baltimore, MD)
- Candidates with previous Utilization Review or Denials/ Appeals experience preferred General Summary of Position Responsible for coordinating and monitoring the ... denial management and appeals process. Combines clinical, business and regulatory knowledge and...Hire preferred and If MFM, maternal fetal medicine (MFM) coding and billing yearly seminars Upon Hire preferred Knowledge,… more
- Clearway Pain Solutions (Annapolis, MD)
- …Reviews and resolves complex issues that result in payer denials, including appeals , coding corrections, medically necessity rules and other related functions. ... The Billing Specialist supports the complete and timely collection of...collection of revenue for assigned groups by performing accurate coding and entry of patient and charge information into… more
- The Wright Center Medical Group (Scranton, PA)
- Job Type Full-time Description POSITION SUMMARY The Billing Specialist is responsible for all aspects of billing inpatient and outpatient claims. The Billing ... Specialist , a key position in the Revenue Cycle, facilitates...billing issues Work closely with team members regarding claim appeals , denials, resolution, and education Understand Medicare, Medicaid and… more
- Jewish Family Services, Inc (Milwaukee, WI)
- Job Type Full-time Description The Medical Billing Specialist will act as the contact between third party billing company, BillCare, and Jewish Family Services (JFS) ... and claims are processed timely. In cooperation with BillCare, submit appeals or redeterminations according to payer's requirements. Communicate with clients to… more
- EXCELSIOR ORTHOPAEDICS GROUP (Buffalo, NY)
- …$19.80 - $35.64 Hourly Travel Percentage None Job Shift Day Billing Specialist Job Summary Busy orthopaedic practice offering challenging work; position responsible ... charge information into billing system and produces account. Assist with coding and error resolution, codes information about procedures performed and diagnosis… more
- Experity (Sioux Falls, SD)
- …take necessary actions to resolve Submit corrected insurance claims and/or appeals , as necessary, with appropriate documentation based on payer guidelines Prioritize ... for their appointment. Billing and Revenue Cycle Management (RCM): Software that manages coding , billing and payer contracts for clinics so they don't have to.… more
- Vinfen (Cambridge, MA)
- …eHana, ARPlus/Hill and Waystar strongly preferred Certified Professional Coder (CPC) orCertified Coding Specialist (CCS) preferred. Must be able to successfully ... Mon-Fri 9am-5pm Salary: $25.00-$26.50 / hour (DOE) The Reimbursement & Billing Specialist is coordinates the analysis and effective resolution of denied claims with… more
- Ohio Department of Aging (Cincinnati, OH)
- …application! What You'll Be Doing: *Reviews incoming claims documents (eg appeals , IC orders, C92/C92As) to determine required action; requests medical documentation ... manage a worklist/caseload that consists of C92/C92A applications,, wages, IC orders, appeals , C92/C92A exams etc. *Ability to issue tentative orders, summarize IC… more
- Alabama Oncology (Birmingham, AL)
- …Business Office Summary: Under general supervision, an AR Account Follow-Up Specialist is responsible for account follow-up for all assigned accounts, resolving ... receivable current including monitoring for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take the appropriate action,… more
- Alameda Alliance For Health (Alameda, CA)
- …the next business day following receipt). Interface with Grievance and Appeals , Claims, Enrollment, IT, Network Management, Pharmacy, Authorizations, and other ... as demonstrated through call and documentation auditing, appropriate Call Disposition coding , as well as an overall acceptable monthly Member Satisfaction Survey… 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
