- St. Luke's University Health Network (Allentown, PA)
- …communities we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party ... orientation. JOB DUTIES AND RESPONSIBILITIES: + Reviews all Inpatient Retroactive Denials in the Denials Management Work Queues for Medical Necessity and… more
- Penn Medicine (Lancaster, PA)
- …day. Are you living your life's work? Summary: + Position Summary: The Utilization Management Specialist - Denials is responsible for evaluating medical ... minimize denied days. + Complete all documentation, including authorizations and denials according to departmental standard operating procedures. + Communicate with… more
- Fairview Health Services (St. Paul, MN)
- **Job Overview** The Physician Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by the ... requirements pertaining to billing, coding, and documentation. The Physician Coding Denials Specialist will also handle audit-related and compliance… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial ... data, payer medical policies, etc.), determines the causes for denials of payment and partners with management ...Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved Specialty Society Coding… more
- HCA Healthcare (Nashville, TN)
- …**_Note: Eligibility for benefits may vary by location._** We are seeking a Clinical Denials Coding Review Specialist for our team to ensure that we continue ... do. We want you to apply! **Job Summary and Qualifications** Seeking a Clinical Denials Coding Review Specialist , who is responsible for applying correct coding… more
- Saratoga Hospital (Saratoga Springs, NY)
- …Under general supervision of the Manager, Health Information Services, the Denials Specialist performs activities to ensure appropriate financial reimbursement ... documentation improvement, Patient Access (PA) and Patient Financial Services (PFS). The Denials Specialist is responsible for tracking denied HIS inpatient… more
- Trinity Health (Hartford, CT)
- …for services. **What you will do** + Responsible for authorization and denials within Case Management ensuring appropriate authorization for inpatient hospital ... with authorization and denial processes + Supports the needs of the Case Management Utilization Coordinator team using data, system reports, and analytics + Develops… more
- Rochester Regional Health (Rochester, NY)
- SUMMARY: Denials ManagementThe C & D specialist is responsible for reviewing accounts which have been denied or underpaid by third party payers and to resolve ... the issues resulting in denial/underpayment and to formally appeal. The specialist will conduct comprehensive reviews of clinical documentation to determine if an… more
- Cardinal Health (Fresno, CA)
- **_What Revenue Cycle Management (RCM) contributes to Cardinal Health_** Practice Operations Management oversees the business and administrative operations of a ... medical practice. Revenue Cycle Management manages a team focused on a series of...account balance is zero. **_Job Summary_** The Coding Denial Specialist is responsible for reviewing, analyzing, and resolving medical… more
- Sanford Health (SD)
- …Research and analyze inpatient related claim edits, returns from providers, denials , internal edits, patient complaints, Patient Financial Services questions and ... Certified Professional Coder (CPC), Certified Outpatient Coding (COC), Certified Coding Specialist (CCS), or Certified Coding Specialist Professional (CCS-P).… more
- CenterWell (Atlanta, GA)
- …trends of consolidated account receivables. Report information to appropriate line management . + Assume responsibilities of Director, as assigned, during Director's ... Develop department tools and training programs, along with the Training Specialist , to encourage growth and development. Analyze/monitors their implementation. **Use… more
- HCA Healthcare (Austin, TX)
- …be a part of our team. **Job Summary and Qualifications** The Inpatient Coding Denials Specialist is a high-level coding expert responsible for investigating and ... from payers, preventing lost reimbursement and promoting denial prevention. The Inpatient Coding Denials Specialist will adhere to all rules and regulations of… more
- Baptist Memorial (Memphis, TN)
- Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary * Position may be filled in Memphis, TN; Jackson , MS The ... Denial Mitigation-Appeal Specialist II RN serves in a key role of...along to healthcare insurance providers in response to post-claim denials received by BMHCC. Physician Advisor communication may be… more
- Baptist Memorial (Memphis, TN)
- …* The position may be filled in Memphis, TN; Jackson, MS The Denial Mitigation-Appeal Specialist II RN serves in a key role of the BMHCC revenue cycle as ... and denial resolution in order to defend our revenue. The Denial Mitigation-Appeal Specialist II RN reviews the denial received from the payer, completes a thorough… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is ... identified by the Revenue Cycle Managers. In addition, the Revenue Cycle Specialist is responsible for resolving all outstanding third-party primary and secondary… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Clinical Documentation Integrity Specialist Part Time, 48 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's ... to be named a Forbes "Best Employer" seven times. Position Summary: The CDI Specialist serves as a liaison between the physicians and hospital departments to promote… more
- BJC HealthCare (St. Louis, MO)
- …Information About the Role** BJC HealthCare is seeking a Clinical Appeals Specialist for infusions! Ideal applicants will have a patient accounts follow up ... the country. **Preferred Qualifications** **Role Purpose** Responsible for resolving clinical denials for BJC hospitals and payors. The Clinical Appeals … more
- Cardinal Health (Nashville, TN)
- …Denial Specialist is responsible for reviewing and resolving claim denials related to prior authorization and medical necessity. This role ensures accurate ... **_What Revenue Cycle Management (RCM) contributes to Cardinal Health_** Practice Operations...appeals or corrected claims to reduce revenue loss. The specialist works closely with clinical, billing, and authorization teams… more
- Butterfly Effects (Deerfield Beach, FL)
- …Full Time | Full benefit package available for full-time employees Medical Collections Specialist Hungry for an opportunity to leverage your experience and skills in ... looking for passionate candidates for the position of Collections Specialist . Butterfly Effects is seeking to add a Collection...CPT codes, and all claim details relating to claim denials or underpayments. + Ensure all research is done… more
- Logan Health (Kalispell, MT)
- …adhere to HIPAA and confidentiality guidelines. Preferred Qualifications: + E xperience in denials management , insurance claims processing , or appeal writing. + ... for questions and concerns. + Responsible for all Medicare, Medicaid, and Case Management insurance denials processing as applicable to assigned area(s). +… more