- Stanford Health Care (Palo Alto, CA)
- …and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding professionals, and ... Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials. This position...required within 180 Days or + CCS - Certified Coding Specialist required within 180 Days or… more
- Stony Brook University (East Setauket, NY)
- …coding issue. Audits. + Follow-up on rejected or denied claims, improper payments and coding issues. + Process appeals . + Liaise with third party billing and ... Revenue Specialist **Position Summary** At Stony Brook Medicine, a...functions including but not limited to: billing, claims analysis appeals , follow-up, financial assistance and customer service. **Duties of… more
- Commonwealth Care Alliance (Boston, MA)
- …provider community. In this highly visible field position, the provider relations specialist acts as the primary liaison between CCA and its providers including ... Referral and authorization; Regulatory compliance; Billing and payments; Complaints and appeals ; Policies and procedures. + Identify opportunities for training and… 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
- 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
- Molina Healthcare (Salt Lake City, UT)
- **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests ... strategy to provide quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred Work hours: Monday- Friday 8:00am - 5:00pm… 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
- 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
- Beth Israel Lahey Health (Burlington, MA)
- …AAPC), CPC-A (Certified Professional Coder - Apprentice through AAPC), or CCS-P (Certified Coding Specialist Physician Based through AHIMA) Experience: 2 - 3 ... all professional services. Reviews provider documentation in order to determine appropriate coding and initiate corrected claims and appeals . Duties include… 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
- Trinity Health (Fort Lauderdale, FL)
- …Integrity staff and providers to educate on improved documentation to support coding . Neurosurgery experience is highly preferred. CPC license is REQUIRED. **What ... you will do:** Responsible for coding and/or validation of charges for more complex service...(PBS) centers, including analysis of clinical documentation, assisting in appeals , root cause analysis and tracking as needed. 6.… 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
- Covenant Health Inc. (Knoxville, TN)
- Overview Coding Specialist , Centralized Coding , Outpatient Coder Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is ... Business Office personnel to resolve issues related to claims, coding , pre-cert, and denials appeals , and verifies...related to claims, coding , pre-cert, and denials appeals , and verifies that appropriate chargemaster rates are used.… more
- Ventura County (Ventura, CA)
- …a Bachelor's Degree in Health Information Management, strong Inpatient and Outpatient coding experience and Certified Coding Specialist certification ... and HCAI requirements; + Reviews insurance denials and submit appeals as necessary, provide education to coders based on...skill with Excel + Must have a current Certified Coding Specialist (CCS) certification + Possession and… more
- Houston Methodist (Houston, TX)
- …in resolution. Engages the coding follow up team for any medical necessity or coding related appeals . + Assures accounts are completed and worked at a high ... At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect...perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the professional fee… more
- Globus Medical, Inc. (Collegeville, PA)
- …Summary** **:** Reporting to the Supervisor, Patient Access, the Patient Access Specialist will focus on providing payer coverage support to customers from the ... initial processing of received documentation through prior authorization, appeals support, detailed claims review, and hotline support. The Patient Access … more
- Ventura County (Ventura, CA)
- Medical Billing Specialist II - Patient Financial Services Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4940099) Apply Medical Billing ... Specialist II - Patient Financial Services Salary $49,302.23 -...the following: + Ensures accuracy and compliance with billing, coding , and follow-up requirements and identifies overpayments and lack… more
