- 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
- TEKsystems (Addison, TX)
- …terminology,medical biller,anesthesia Additional Skills & Qualifications - Proven experience as an Appeals Specialist or in a similar role within a healthcare ... reimbursement issues to identify the root causes. - Initiate and manage the appeals and arbitration process for denied or underpaid claims, ensuring timely and… more
- Northwell Health (Melville, NY)
- …serves as a resource for the Health System. Reviews denial trends and identifies coding issues and knowledge gaps. Job Responsibility + Serves as liaison between the ... current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness… more
- Northwell Health (Melville, NY)
- …as a resource for the Health System. Reviews denial trends and identifies coding issues and knowledge gaps. Job Responsibility Serves as liaison between the patient ... current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness… more
- University of Washington (Seattle, WA)
- …Patient Financial Services Department** has an outstanding opportunity for a **Clinical Appeals and Disputes Nurse.** **WORK SCHEDULE** + 100% FTE + 100% Remote ... + Days **POSITION HIGHLIGHTS** The Clinical Appeals and Disputes Nurse ensures that payers are prepared...initiatives + Assess the quality of charge capture and coding as they relate to clinical denials; assist revenue… more
- Molina Healthcare (WI)
- JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are ... Utilization Review and/or Medical Claims Review experience. Knowledge in coding : DRG, ICD-10, HCPCS codes is highly preferred. Additional...reviews of previously denied cases in which a formal appeals request has been made or upon request by… more
- Fairview Health Services (St. Paul, MN)
- …Info Admin or Registered Health Info Tech or Certified Inpatient Coder (CIC)or Certified Coding Specialist **Preferred Qualifications** + BS/BA in HIM + 1 year ... **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts...medical records and coding guidelines to formulate coding arguments for appeals and/or coding… more
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials ... to ensure compliance. + Collaborate with clinical staff and coding teams to obtain necessary documentation for appeals... coding teams to obtain necessary documentation for appeals + Track and monitor appeal status, maintaining detailed… more
- HCA Healthcare (Ocala, FL)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? We have ... caring group of colleagues. Do you want to work as a Clinical Denial Coding Review Specialist where your passion for creating positive patient interactions is… more
- Tidelands Health (WV)
- …Team Tidelands and help people live better lives through better health!** **Medical Coder/ Coding Specialist II** Are you passionate about quality and committed ... Coder - American Academy of Professional Coders Required or + Certified Coding Specialist - American Health Information Management Association Required or… more
- Huron Consulting Group (Chicago, IL)
- …the expert you are now and create your future. Job Description Summary The Coding Integrity Specialist will be responsible for executing a variety of activities ... involving the coding of medical records, resolving coding related...appeals . + 2+ years of experience as a coding auditor with proven accuracy and compliance. + Required… more
- Seattle Children's (Seattle, WA)
- …ensure coding and documentation compliance. **Required Credentials** Certified Coding Specialist -Physician Based (CCS-P) certification by the American Health ... creation of educational materials. Experience in revenue cycle functions, including coding denial management and appeals process. Experience in research… 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** PRN43924B **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
- Geisinger (Danville, PA)
- …management, physicians, clinical and non-clinical personnel utilizing the national correct coding standards, approaches, and industry standard coding rules to ... Biller through AAPC + Applies expanded knowledge of CPT, ICD-10 and HCPCS coding skills toward the maintenance and development of prospective claim edits and… more
- Hartford HealthCare (Farmington, CT)
- …. Prepare, document and submit appeals for DRG denials, ensuring appeals are well-supported with clinical evidence, coding guidelines, and regulatory ... and other common practices across the system. *_Position Summary:_* The Denial Specialist is responsible for reviewing, analyzing and appealing denials related to… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Coding Specialist , Centralized Coding [Type, HPPP, Shift] Covenant Health Overview: Covenant Health is the region's top-performing healthcare ... 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