- Guthrie (Sayre, PA)
- Summary The Denial , Appeal , and Audit Manager is responsible for the oversight and management of all payer denials, appeals, and audit processes ... claim denials, effective appeal strategies, and proactive audit response. The manager leads a team...dashboards and reports to track denial rates, appeal success rates, and audit recoveries +… more
- BronxCare Health System (Bronx, NY)
- …staff, the Appeal Manager is responsible to develop a strong appeal letter that will result in the denial being overturned providing the hospital ... the care and services provided to the patient. The Denial Manager will assist the department's leadership...staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal and… more
- University of Southern California (Alhambra, CA)
- …determining the need for appeal . Performs all 1st and 2nd level coding-related denial appeals. All tasks & duties to be perform in compliance with federal & ... IP & OP healthcare services provided to covered patients. Manages the denial management process for coding-related denials, triage denied claims to distinguish… more
- Guthrie (Sayre, PA)
- …Insurance Billing Specialists I and related support staff. Works closely with Director, Manager , Supervisor and Application Analyst on day to day priorities and to ... to determine specific issues and patterns that need to be addressed. Serves on Denial Task Force(s) and assists in developing action plans to reduce denials and… more
- Molina Healthcare (NE)
- …proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified ... medical claims and previously denied cases in which an appeal has been made, or is likely to be...guidelines and other appropriate criteria with medical directors on denial decisions. + Supplies criteria supporting all recommendations for… more