- St. Mary's Healthcare (Amsterdam, NY)
- …government claim denials and audit requests and coordinates attempts to overturn denials by drafting appeals , negotiating with payers, or following up with ... payer utilization review departments in attempts of obtaining authorizations and claim payment. * Establishes and maintains positive and cooperative relationships with medical staff and care coordination leaders to ensure ongoing compliance with utilization… 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 ... functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** +...Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved Specialty Society Coding… more
- University of Utah (Salt Lake City, UT)
- …Number** PRN39530B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt ... -H), Certified Professional Coder-Payer ( CPC -P), Certified Coding Specialist ( CCS ), Certified Coding Specialist ...knowledge of revenue cycle. + Working knowledge of insurance denials , appeals and expected reimbursement rates. +… more
- Carle (Urbana, IL)
- Outpatient Denial/ Appeals Specialist - RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + ... documentation review to establish and manage clinical and prior authorization denial appeals for the Carle enterprise. Represents Carle in clinical meetings and… more
- St. Luke's University Health Network (Allentown, PA)
- …clean claim submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across the network. Utilizes ... coding errors and MUE frequency for clean claim submission + Resolve coding denials through claim correction or appeal. Claim corrections will be made after review… more
- University of Washington (Seattle, WA)
- …thoroughly, and communicated payer decisions in a timely manner + Review clinical denials and initiate appeals process + Conduct medical necessity reviews, based ... PATIENT FINANCIAL SERVICES Department** has an outstanding opportunity for a **CLINICAL APPEALS AND DISPUTES NURSE** **Work Schedule** + 100% FTE + 100% Remote… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The DRG Appeals Analyst - CDI Liaison is responsible for analyzing medical records, claims data, and coding on all diagnoses and procedures (both ... the patient's treatment have been applied to the claim. **RESPONSIBILITIES** 1. Analyzes denials and determines when an appeal should be filed to the payor.… more
- Houston Methodist (Houston, TX)
- …This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the ... At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect...queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits… more
- Hartford HealthCare (Newington, CT)
- …and homecare to insure optimal revenue cycle performance. The AR Follow Up & Denials Specialist is responsible for resolving unpaid third party balances on $550 ... million in active inventory and $70 million in denials through account follow up, appeals and resubmission actions. This position reports directly to the AR… more
- Robert Half Accountemps (Charleston, SC)
- Description We are seeking a Medical Billing Specialist to join our team in the healthcare industry based in Charleston, South Carolina. The role is critical in ... with a focus on insurance claims, account receivables, claim denials , and medical coding. This role offers a contract...accounts receivable and conduct necessary follow-ups * Efficiently file appeals and work on denied claims * Contribute to… more
- Randstad US (Franklin, TN)
- …by managing various aspects of the revenue cycle process. This includes handling appeals and denials management to ensure that claims are processed efficiently ... revenue cycle specialist . + franklin , tennessee + posted 7...and track claim statuses to ensure timely reimbursement. + Appeals and Denials Management: Review, analyze, and… more
- Beth Israel Lahey Health (Danvers, MA)
- …Billing Office. 15. Independently works on the resolution of complex claims issues, denials and appeals . 16. Completes projects and research as assigned. 17. ... you're making a difference in people's lives.** The Billing Specialist role specializes in high dollar claims, aged claims...complex specialties. This role identifies and works to resolve denials to uncover root cause and accurately appeal claims… more
- The Mount Sinai Health System (New York, NY)
- …and quality issues Responsible for the maintenance of accurate data for approvals, denials and appeals (in coordination with UM Manager and management). ... or Departmental Manager. In relationship to UM Insurance verification; authorizations and approvals; denials and appeals , will assist in the processing of mail.… more
- UNC Health Care (Goldsboro, NC)
- …legal, and compliance guidelines Processes all assigned government and nongovernment accounts and denials for complex financial appeals , with a goal of bringing ... of the unique communities we serve. Summary: The Government-Non-government Specialist is responsible for reviewing, submitting and resolving assigned insurance… more
- Boys Town (Omaha, NE)
- …claims related to clinical/facility charges. Reviews and completes daily workflow of denials and no response from insurance payers for HCFA/UBO4, chart notes/faxes ... and appeals worked in a timely manner to ensure claims...resubmits claims for payment to prevent and reduce further rejections/ denials . Communicates common denials /rejections to help streamline… more
- Weill Cornell Medical College (New York, NY)
- Title: Revenue Cycle Specialist -Revenue Integrity Location: Midtown Org Unit: AR - Coding Medicine Work Days: Weekly Hours: 35.00 Exemption Status: Non-Exempt Salary ... Certified Professional Coder to investigate and resolve coding related insurance payment denials . The CBO partners with WCM Clinical Departments to increase and… more
- Baptist Memorial (Jackson, MS)
- Summary The Accounts Receivable Follow Up Specialist performs all collection and follow up activities with third party payers to resolve all outstanding balances and ... receivable, percentage of accounts aged greater than 90 days, cash collections, and denials resolution in support of the team efforts in the achievement of accounts… more
- Robert Half Accountemps (Van Nuys, CA)
- …PPO/HMO, and Medical managed care * Provide training for Collector I positions * Appeals and denials management. * Engage in Appeals , Billing Functions, ... to collect insurance payments. Requirements Medical Billing, Medical Collections, Medical Appeals , Medical Denials , HMO PPO, Hospital Billing, Hospital Revenue… more
- R1 RCM (Salt Lake City, UT)
- …experience and/or + Minimum 3 years' revenue cycle management in back-end working denials , appeals , and billing + Knowledge of Medical Necessity Requirement For ... As our Revenue Integrity specialist , you will be responsible for key operational...key operational functions to include charge capture, clinical billing, appeals and advanced third-party or government audits. Every day… more
- The Mount Sinai Health System (New York, NY)
- …entry of office, inpatient, and/or outpatient charges. Runs and works missing charges, edits, denials list and processes appeals . Posts denials on a timely ... **JOB DESCRIPTION** The Procedural Billing Specialist III is a senior level individual, responsible for multiple components of the billing process for specialized or… more