- Vivo HealthStaff (Burbank, CA)
- …Clinical Supervisor, UM Denial Compliance Location: Los Angeles Metropolitan Area Position Type: Hybrid (85% remote, 15% onsite in Burbank, CA) Company: Vivo ... HealthStaff Overview: Vivo HealthStaff is seeking a Clinical Supervisor for UM Denial Compliance. This role is essential in ensuring a high-quality, efficient, and compliant denial process, adhering to all regulatory, accreditation, and health plan standards… more
- Grady Health System (Atlanta, GA)
- …High School Diploma or GED is required At least 2 years relevant coding and abstracting experience in an acute care hospital. Experience with Epic and 3M CAC systems ... preferred. Certification as a Certified Professional Coder (CPC) or Certified Outpatient Coding (COC), formerly Certified Professional Coder-Hospital (CPC-H), Certified Coding Specialist (CCS or CCS-P). Accredited Coding Certificate program (AAPC or AHIMA)… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …Manage department budget, staffing, and training needs. Function as Utilization Review/ Denials Manager as required. Qualifications Registered Nurse (RN) with a Texas ... license; relevant certification (CCM, ACM, CCM-RN) preferred. Proven leadership experience in acute care, utilization review, case management. Strong working knowledge of hospital billing, managed care systems, and discharge planning. Excellent skills in… more
- American Hospice and Home Health Care Services (Pleasanton, CA)
- …(EOBs) and electronic remittance advice (ERAs) to identify payment trends and denials . Research and appeal denied or underpaid claims as necessary. Verify insurance ... Brightree, Kareo, or similar platforms). Proficient in interpreting EOBs, claim denials , and HCPCS coding. Strong attention to detail and excellent organizational… more
- TeamHealth (Louisville, TN)
- …Representative is responsible for providing support in all aspects including Denials , Appeals and Accounts Receivable teams. Essentials Duties and Responsibilities ... Processes enterprise task manager (ETM) worklist in Accounts Receivable, Denials and Appeals Reviews rejections to identify trends and carrier issues require… more
- University Hospitals (Beachwood, OH)
- …*Support for inappropriate level of care and decreased inpatient bed day denials *Continuity and coordination of care *Appropriate and timely authorization for level ... of care *Decreased denials *Appropriate reimbursement Perform timely and accurate review, denial...supervisor to support training, and reinforcement resulting in decreased denials . 20% Conduct all UM activities with a focus… more
- Columbia University (Fort Lee, NJ)
- …and accuracy. Responsibilities Accounts Receivable Coding Research root causes of claim denials and apply knowledge of payer policies to determine appropriate course ... Reviews charge correction requests and ensures accuracy prior to resubmission. Denials Management Collaborates with Accounts Receivable staff to resolve denied or… more
- ASCENSION DEPAUL SERVICES (New Orleans, LA)
- …to ensure proper submission of claims and works to reduce or correct denials of claims. Determines appropriate staffing levels and interviews, hires, on boards, ... conducts performance reviews and works with Human Resources on progressive discipline of employees. Collaborates with all members of Executive Leadership to achieve organizational goals and objectives. Involved in planning, implementing, evaluating, and… more
- Community First Medical Center (Chicago, IL)
- …in setting up mutually agreeable payment arrangements. 8. Review payment denials and discrepancies identified through EOB, Remittance Advices or Payor ... correspondence. 9. Contact various departments throughout Community First Medical Center to obtain additional information. 10. Post all payments and adjustments to the appropriate patient accounts. Community First Medical Center offers benefits to all its… more
- Quipt Home Medical Corp (Mesa, AZ)
- …all assigned procedures, including but not limited to, billing, posting, insurance, denials , inquiries, orders, and paperwork are processed in an accurate and timely ... manner. All patient files and information are maintained and current at all times. Participates in company training programs Demonstrates excellent oral and written communication skills with referrals, handling complaints and qualifying orders. Timely filing… more
- Chubb (Southfield, MI)
- …necessary claim information. Prepare detailed reports on investigations, settlements, claim denials , and evaluations of parties involved. Set reserves within your ... authority limits and recommend reserve adjustments to the Team Leader. Regularly review claim progress with the Team Leader, identifying challenges and suggesting possible solutions. Prepare and present for review any unusual or potentially undesirable… more
- Equiliem (Livermore, CA)
- …computers, telephones, calculators, fax machines and devices-level of competency 90%. Working Denials in a timely manner that results in cash collection goals. ... when handling confidential information. Regular attendance and punctuality. Key Results: Working Denials in a timely manner that results in cash collection goals.… more
- Washington University (St. Louis, MO)
- …charge capture, coding, claims submission, accounts receivable management, and denials management. Lead continuous improvement initiatives to enhance billing ... efficiency, revenue realization, and patient satisfaction. Develop and maintain performance dashboards and KPIs for revenue cycle metrics. Direct activities between WashU Physicians Billing Service and Medical School Finance (journals, report requests,… more
- OPTIMUM PROFESSIONAL PROPERTY MANAGEMENT, Inc. (Irvine, CA)
- …attorneys on all pending matters (requests, complaints, etc.) Process approvals and denials of all requests based on client decisions. File creditors' claims with ... the court as needed. Meet with the Community Manager before a board meeting to assist with any matters relating to collections. Process requests from Collection Attorneys, Community Association Managers, and Homeowners Process collections reports as requested… more
- Ensemble Health Partners, Inc. (Greenville, SC)
- …Understanding of Revenue Cycle including admission, billing, payments, and denials . Comprehensive knowledge of patient insurance process for obtaining authorizations ... and benefits verification. Knowledge of Health Insurance requirements. Knowledge of medical terminology or CPT or procedure codes Join an award-winning company Five-time winner of "Best in KLAS" 2020-2022, 2024-2025 Black Book Research's Top Revenue Cycle… more
- Amgen, Inc. (Philadelphia, PA)
- …troubleshoot and resolve initial and ongoing reimbursement issues (PAs, denials , appeals, reauthorizations, overrides, billing problems) Liaise with medical offices ... as necessary to obtain insurance authorizations Counsel patients and family on insurance and reimbursement options Identify general and specific adherence trends and suggest appropriate action Report on weekly changes in patient status, current adjudication… more
- UPMC Senior Communities (Washington, PA)
- …ability to recommend corrective action steps to eliminate future occurrences of denials . Assist in claim appeal process and/or perform follow-up in accordance with ... and office equipment is needed. Must be multi-disciplined in billing, collections, denials , credit balances and/or the various payers. Prior collections or medical… more
- Fraser (Minneapolis, MN)
- …activities: Processing refunds, billing corrections, and monitoring and responding to billing denials in a timely manner. Pursues payments from third party carriers ... and patients. Collaborate with third party carriers, families, and other members of revenue cycle team to timely and accurately process claims. Verify insurance coverage and other related data with third party carriers. Sets up financial agreements with… more
- US Physical Therapy (Englewood, CO)
- …of accounts and collect overdue payments. Facilitate a proactive approach to all denials , denial trends, and implementation of a process to lessen the denial ... frequencies. Monitor late and/or pending payments and produce aging reports. Maintain all appropriate filing systems to ensure the completeness of data. Other duties as assigned. Company Perks: Excellent benefits package including Medical, Dental, & Vision… more
- UnitedHealth Group (Keller, TX)
- …transition procedures) Explain medical benefits/coverage specifics (eg, procedures/amounts covered, denials of coverage, appeal rights Access insurance plan systems ... to verify insurance eligibility/benefits for patients and seek additional information as necessary Input/update patient demographic data into computer system Update/upload patient care data (eg, care plan data, inpatient data, patient program flags) in… more
