- Magellan Health Services (San Diego, CA)
- …ensuring documents meet standards and are accurate. General Job Information Title Appeals Coordinator Grade 19 Work Experience - Required Customer Service ... Coordinates appeals process as assigned, attends to risk management...requests. In some cases may be combined with Grievance Coordinator functions. + Maintains a caseload and monitors day… more
- Universal Health Services (Chicago, IL)
- Responsibilities JOB SUMMARY: Responsible for all denial and appeal activities for the Utilization Management department, including Expedited Appeals , Standard ... Reviews, and State Fair Hearings. Review clinical information for all appeals utilizing nationally recognized criteria to determine medical necessity of services… more
- UCLA Health (Los Angeles, CA)
- …for accuracy, confirming the receipt of necessary documentation to support the denial and ensuring compliance with all contractual obligations and state and federal ... with them for clinical guidance in resolving cases. You will also document appeals in the tracking system and maintain relevant statistical data. Salary Range:… more
- Penn Medicine (Philadelphia, PA)
- …Confidentiality, and continuity of communication. + Supports the activities of the Clinical Appeals Coordinator in all phases of the Clinical Quality and ... of patient related information including the hospital database, reports and all denial and appeals correspondence. + Maintains database for the department… more
- University of Virginia (Charlottesville, VA)
- …policies and guidelines. + Works directly with departments and carriers on denial resolution. + Participates in on-going training to maintain coding certification ... through AAPC. + Other duties as identified by Unit Coordinator , Supervisor and/or Manager. Position Compensation Range: $18.37 - $28.47 Hourly **MINIMUM… more
- CVS Health (Fresno, CA)
- …between 9am-1pm. Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may ... responses from multiple business units. Ensure timely, customer focused response to appeals . Identify trends and emerging issues and report and recommend solutions.… more
- Hartford HealthCare (Southington, CT)
- …of Connecticut's most comprehensive healthcare network as a Quality Improvement Coordinator . Hartford HealthCare at Home, the largest provider of homecare services ... clients and their clients' families. Basic Purpose of the Position: **Manages appeals at the branch level including clinical documentation review, training, and… more
- Trinity Health (Darby, PA)
- …**Description:** Trinity Health Mid-Atlantic is looking for Clinical Pre-Service Nurse Coordinator to join our Pre-Service team! **Employment Type:** Full Time ... University Drive Newtown, PA 18940. **Summary:** The Clinical Pre-Service Nurse Coordinator is directly responsible for reviewing pre/post service initial denials,… more
- Trinity Health (Livonia, MI)
- …guidelines for admission or continued stay. * In the event of an inpatient denial by the payer, obtains further documentation from the physician to support an IP ... to determine if a case should go to the Appeals Team. * Assists other departments in the reimbursement...issues that contribute to denials. The Utilization Review (UR) Coordinator I colleague is responsible for conducting the utilization… more
- Universal Health Services (Doylestown, PA)
- …Facilitates and fully documents physician peer-to-peer reviews, and prepares and submits written appeals in response to denial of initial or continued stay ... Responsibilities Foundations Behavioral Health is currently hiring a full-time Utilization Review Coordinator to support our UM Department in Doylestown, PA. This is… more
- Athena Health Care Systems (Seymour, CT)
- Resident Care Coordinator Assistant 7 am - 3 pm, Full-Time Shady Knoll Health Center - Seymour, CT Posted 2 months ago We are hiring a Resident Care Coordinator ... to grow within the company. As a Resident Care Coordinator Assistant, you will assist the Resident Care ...certifications and recertification. + Mails and tracks all Medicare denial letters. + Retrieves/prints and faxes medical records to… more
- Weill Cornell Medical College (New York, NY)
- Title: Revenue Cycle Coordinator -Revenue Integrity (Remote) Location: Midtown Org Unit: AR - Coding Surgical Work Days: Exemption Status: Non-Exempt Salary Range: ... billing. + Performs extensive follow-up to investigate and resolve payment denial trends. + Resolves outstanding accounts utilizing ancillary applications and… more
- Baystate Health (Springfield, MA)
- **Summary:** The Referral Authorization Coordinator is responsible for providing a variety of support services that are essential to the efficient operation of the ... insure proper payment for services provided. **4)** Consistently monitors and works denial and no referral reports to obtain prior authorizations and referrals.… more
- Henry Ford Health System (Wyandotte, MI)
- …as all other related documentation requirements. Coordinates the appeal process whenever a denial from our fiscal intermediary occurs. Is the primary author of the ... liaison between HIM and patient billing services regarding all appeals and their status. + Writes, assembles and submits...and necessary 'care to mitigate our risk of claim denial . + Manage the medical necessity denial … more
- Hackensack Meridian Health (Hackensack, NJ)
- …of information to insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record utilization reviews. + ... and serve as a leader of positive change. The **Case Management Care Coordinator , Utilization Management** is a member of the healthcare team and is responsible… more
- Hackensack Meridian Health (Brick, NJ)
- …of information to insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record utilization reviews. + ... healthcare and serve as a leader of positive change. The **Care Management, Care Coordinator ** , **Utilization Management** is a member of the healthcare team and is… more
- Hackensack Meridian Health (Neptune, NJ)
- …of information to insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record utilization reviews. + ... and serve as a leader of positive change. The **Care Management, Care Coordinator , Utilization Management** is a member of the healthcare team and is responsible… more
- Hackensack Meridian Health (Hackensack, NJ)
- …of information to insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record utilization reviews. + ... and serve as a leader of positive change. The Case Management Care Coordinator , Utilization Management is a member of the healthcare team and is responsible… more
- Healthfirst (NY)
- …for clinical review. + Notifies team lead of identified patterns of appeals , claim errors, configuration issues or other systemic problems identified during appeal ... Claims, DSE, and E&B to resolve member and provider appeals . + Ensures appeals and grievances are...makes calls and draft letters as needed. + Request denial files from delegated vendors and prepares cases for… more
- Children's Hospital Boston (Boston, MA)
- 75535BRJob Posting Title:Patient Accounts Coordinator IDepartment:Orthopedic Surgery and Research AutoReqId:75535BRStatus:Full-TimeStandard Hours per Week:40 Job ... Posting Category:Administration, FinanceJob Posting Description:The Patient Accounts Coordinator I will be responsible for: + Assisting Call Center Agents with… more