- Rady Children's Hospital San Diego (San Diego, CA)
- …auditing the billing data for accuracy, trending and tracking A/R and denials , identifying root cause. The AR Analyst responsibilities also include project analysis ... along with daily operational issues associated with AR and denials . The Analyst supports the overall MPF business by...policies impacting revenue cycle and to aid in preventing denials . The AR Analyst works with various levels of… more
- Stony Brook University (East Setauket, NY)
- …Patient Accounting Department resolving hospital Managed Care payment variances and/or denials . **Job Responsibilities may include the following, but are not limited ... tracks and pursues un-timely, under-paid and denied accounts. + Collaborates on denials prevention initiatives. + Liaises with Managed Care Contracting and Insurance… more
- Northwestern Mutual (Franklin, WI)
- …complaints. Responsible for facilitating, case clinics, rounding, review of claim denials , appeals, depositions and claim settlements Provides prompt case review and ... initiates decisive action on claim approvals, denials and appeals of denied claims referred from the teams. Serves as a liaison with the Law Department, initiating… more
- Tidelands Health (Myrtle Beach, SC)
- …and accuracy. Responsible for resolving coding edits, account checks, rejections, and denials to ensure proper reimbursement of service rendered and to maintain an ... by a payer or contract + Review and resolve clearinghouse rejection errors, denials , and charge review/claim edits daily. Also reviews accounts returned from various… more
- Alameda Health System (San Leandro, CA)
- …and referral coordination and revenue cycle operations (billing, claims, denials , authorizations, registration related edits, education with clinicians) at multiple ... - scheduling, registration, and referral coordination. Revenue - billing, claims, denials , authorization, and registration impact Determines access and revenue cycle… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …entity/general ledger account using designated adjustment codes. Processes payments and denials with the correct denial/remittance codes and applies denials ... /payments to the appropriate account/liability bucket. Handles processing of Non-Sufficient Funds (NSF) payments. Conducts in-depth research to resolve any balancing issues or to reconcile unidentified payments posted to clearing accounts. Identifies issues… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …data gathering tools to document and analyze patterns of code payments and denials , medical policy changes, and coding changes. + Research and interpret medical ... patterns and/or trending to confirm alignment of code payments, changes and denials , and medical policy changes. + Contribute to the analysis and decision-making… more
- Stony Brook University (East Setauket, NY)
- …but are not limited to:** + Prepare and submit hospital claims. Review denials . Investigate coding issue. Audits. + Follow-up on rejected or denied claims, improper ... claims/insurance companies and review to increase revenue and prevent unnecessary denials . + Assist the supervisor in scheduling, timesheet, leave requests,… more
- Wipfli LLP (Milwaukee, WI)
- …reimbursement experience including knowledge in pre-authorization, pre-admission processes, denials management, claims adjudication, etc. + Provider compliance and ... reimbursement business process optimization experience including knowledge of edits, denials , holds, reimbursement, etc. + Senior living cost reporting data analysis… more
- Stony Brook University (Stony Brook, NY)
- …on all other payers. + Active participation with the physician and payer to prevent denials . Reviews cases for potential change in level of care with the CM and ... + Reviews cases daily from admission through discharge to prevent denials .This includes patient and family contacts, insurance authorizations, tests, procedures,… more
- Christus Health (Emory, TX)
- …and monthly reports and reports trends to clinic management, such as denials , unbilled, and audits. Responsible for the implementation of front-end processes. ... Reviews and researches all information on hold reports to complete the billing processes. Resolves billing problems with patients and the CBO. Advises patients on patient procedures/processes to ensure payments are collected timely. Oversees inventory… more
- Saisystems International (Bridgeport, CT)
- …software. Hands-on knowledge of RCM workflows (eligibility, coding, billing, denials , collections). Experience working with cross-functional Agile teams. Familiarity ... with healthcare data standards such as FHIR, HL7 and 837/835/270/271. Excellent communication, analytical and problem-solving skills. About Saisystems International Saisystems International is a healthcare and technology company with 500-1,000 employees,… more
- Yellow Cab (Chandler, AZ)
- …Motor Vehicle Report (MVR) ( DUI's and at-fault accidents are automatic denials ) Friendly and professional demeanor, with strong customer service skills Willingness ... to follow all traffic regulations and company policies Ability to produce a clean drug test (that includes marijuana) Benefits: Control over your schedule and income potential Diverse daily interactions, meeting new people, and experiencing different locations… more
- US Physical Therapy (Garden City, NY)
- …commercial insurance claims from submission through payment + Follow up on denials , rejections, and appeals to ensure reimbursement + Communicate with insurance ... carriers and patients to resolve issues + Track A/R reports and maintain accurate patient account records + Collaborate with team members to improve billing and collection processes **Qualifications** + 2+ years of experience in medical billing/claims… more
- Alameda Health System (San Leandro, CA)
- …patient care team and vendors to procure DME (Durable Medical Equipment). 8. Notifies denials to the attending MD and treatment team members via EHR. 9. Reviews ... patient Account notes in EHR as needed for account updates and insurance accuracy. 10. Completes the DHCS PASSR for patients being referred to a SNF or Morton Bakar Center. 11. Independently processes the denial Work Ques and Patient Account Work Ques in EHR.… more
- Stanford Health Care (Newark, CA)
- …with patients regarding insurance authorizations (including approvals and denials ) and request required clinical documentation when necessary **Education ... Qualifications** + High School Diploma or GED High school diploma or GED equivalent. **Experience Qualifications** + Two (2) years of progressively responsible and directly related work experience in a healthcare setting, preferably in a call center… more
- Stony Brook University (Stony Brook, NY)
- …to include tracking hours used/taken, sending timely notifications of leave approvals or denials , and working closely with payroll to ensure that pay for employees ... is accurate. + Assist in coordinating fit-for-duty requests for employees returning from extended leave of absences. + **Employee Leave Communications:** + Work closely with employees to ensure that all relevant completed medical documentation is submitted for… more
- Sun Pharmaceuticals, Inc (Washington, DC)
- …and reimbursement issues encompassing coverage, prior authorizations, appeals, exceptions, denials , coding and payer payment guidelines, payer policies, sites of ... care, understanding of coding guidelines (CPT/J-Code/ICD-10), statutory or commercial pricing structures or mandates, and quality programs related to value based care and clinical care pathways. Responsibilities include: + Incorporate knowledge of dynamic and… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …flexibility in scheduling, including evenings and weekends, to address pharmacy-related denials + Educates physician reviewers and clinical review staff on managed ... care and Medicaid policies and procedures D. Conducts staff and medical director audits on appeal activities + Assists with appeal file preparation for NCQA file reviews + Supports the development of corrective action plans based on trended audit findings E.… more
- Caris Life Sciences (Irving, TX)
- …and payer compliance. + Collaborate with payers to resolve eligibility discrepancies, denials , and escalations. + Work closely with Revenue Cycle leadership to ... identify trends, gaps, and opportunities for process improvements. + Implement and update policies and procedures to ensure compliance with regulatory and payer requirements. + Train, coach, and mentor team members to enhance knowledge of payer guidelines,… more
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