- HCA Healthcare (Nashville, TN)
- …worth of each individual is recognized. Submit your application for the opportunity below: Clinical Denials Coding Review SpecialistParallon. **Benefits** ... **_Note: Eligibility for benefits may vary by location._** We are seeking a Clinical Denials Coding Review Specialist for our team to ensure… more
- Hartford HealthCare (Farmington, CT)
- …. Conduct a thorough review of medical records, coding , and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit ... Related Group) validation denials . This role involves validating the coding and clinical accuracy, ensuring proper documentation, and collaborating with… more
- Houston Methodist (Houston, TX)
- … staff; and functions as clinical subject matter expert related to coding denials and appeals. **PEOPLE ESSENTIAL FUNCTIONS** + Communicates openly in a ... At Houston Methodist, the Coding Charges & Denials Specialist is...payers to successfully clear front end claim edits, appeal clinical denials , and address customer service inquiries.… more
- PeaceHealth (Vancouver, WA)
- …for new correspondence related to DRG denials . + Routes clinical denials and rebuttals to different departments for review /appeal. + Compiles and sends ... **Description** PeaceHealth is seeking a Coding Denials Specialist. This position is remote but does require the associate to live / work in OR, WA, AK or TX to… more
- R1 RCM (Salt Lake City, UT)
- …Skills:** + High School Diploma or GED required CCS-P, CPC + Three (3) years of denials coding experience + Three (3) years of claims experience + Professional ... sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Denials ** **Coder III** you will be responsible for reviewing clinical… more
- Cardinal Health (Fresno, CA)
- …payers to ensure efficient claims resolution **_Responsibilities_** + Review payer denials and rejections related to coding issues and take corrective ... Denial Specialist is responsible for reviewing, analyzing, and resolving medical claim denials and rejections related to coding discrepancies. This role ensures… more
- Kaleida Health (Buffalo, NY)
- **Director Clinical and DRG Denials ** **Location:** Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1 Job ... Description **Summary:** The Director, Clinical & DRG Denials provides ...managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG… more
- Guidehouse (Huntsville, AL)
- …Required** **:** None **What You Will Do** **:** The **R** **emote** ** Clinical Denials RN** is responsible for review , analysis and appeal of clinical ... expected outcomes daily + Familiarity with medical records assembly & clinical terminology, coding terminology additionally beneficial + Personal responsibility,… more
- St. Luke's University Health Network (Allentown, PA)
- …and tracks outcomes regarding appeal process. Assists billing staff regarding outpatient denials for experimental, coding or other issues that may require ... clinically appropriate. + Investigates managed care and commercial insurance rejections, denials for possible experimental services and coding issues, providing… more
- University of Michigan (Ann Arbor, MI)
- …as an RN is also acceptable. + Minimum of three years of inpatient coding experience or equivalent experience as a clinical documentation specialist. **Desired ... Denials Prevention/Appeals Specialist Apply Now **Job Summary** The...educational program development preferred. + Extensive knowledge of ICD-10 coding guidelines and clinical criteria for disease… more
- St. Mary's Healthcare (Amsterdam, NY)
- …based on experience and other factors permitted by law. Responsibilities: * Uses clinical and coding knowledge to ensure accurate and compliant charge items ... recognize and resolve billing inconsistencies. * Reviews commercial and government claim denials and audit requests and coordinates attempts to overturn denials … more
- BAYADA Home Health Care (Orlando, FL)
- …BAYADA Home Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. ... match, direct deposit, and employee assistance program **Responsibilities:** + Review clinical information for appropriateness, congruency, and...MCM. + Prevent or decrease the occasion of Medicare denials by assuring proper coding on the… more
- BAYADA Home Health Care (Orlando, FL)
- …a full time OASIS Review and Coding Manager. The OASIS and Coding Review Manager provides support to all BAYADA Home Health Care Medicare service offices ... about BAYADA Benefits, click here (https://www.bayada.com/benefits/) . **Responsibilities:** + Review clinical information for appropriateness, congruency, and… more
- Children's Hospital Boston (Boston, MA)
- …compliance and Share Service Center - Coding and billing to manage clinical validation denials . + Collaborating on appeal processes and assessing trends to ... preferred. + 2 years of clinical chart review experience applying ICD coding knowledge to medical record review Office/Site Location:BostonRegular,… more
- Independent Health (Buffalo, NY)
- …benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist-Senior will be responsible for reviewing ... coding and clinical decisions on cases involving complex clinical ...guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records,… more
- Western Washington University (Bellingham, WA)
- …for compliance and any legal updates or other considerations. + Reviews claims denials and rejections pertaining to coding and medical necessity issues, and ... revenue. + Analyzes and resolves complex billing related claim denials in a manner that ensures accurate and optimal...in response to newly implemented workflows or laws/regulations. + Review spreadsheets for coding compliance to ensure… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …with vendor quires and questions related to assigned multi-specialty coding inventories. + Review ETM coding denials for coding error. ETM ... an appropriate system note. May need to email or telephone MPlP office to further address non- coding denials . This will be done timely for MPIP to work the … more
- Banner Health (OH)
- …Reviews medical records. Performs an audit of clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that coding ... diagnostic and procedure code assignments. Collaborates on DRG and coding denials , billing edits/rejections to provide ...to understand the Medicare Prospective Payment System, and the clinical coding data base and indices, and… more
- Omaha Children's Hospital (Omaha, NE)
- …and assigning valid CPT, ICD10, and HCPCS codes for complex surgical cases, and/or coding verification and review to ensure coding accuracy and appropriate ... to regulation (eg, ICD10CM, CPT, HCPCS, UHDDS, and HIPPA coding guidelines) and/or abstract accurate clinical information...accuracy of billing. * Trends identified from documentation and denials . * Provide input timely responses to coding… more
- Rush University Medical Center (Chicago, IL)
- …utilization. Provide feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding , and implement ... EMR charge capture support. 7. Serves as a liaison point of contact for clinical coding inquiries and communication for professional billing revenue cycle 8.… more