- Guthrie (Sayre, PA)
- Summary The Denial , Appeal , and Audit Manager is responsible for the oversight and management of all payer denials, appeals, and audit processes ... claim denials, effective appeal strategies, and proactive audit response. The manager leads a team...dashboards and reports to track denial rates, appeal success rates, and audit recoveries +… more
- Sanford Health (SD)
- …matter expertise and possesses the ability to identify resources and support processes for the appeal and denial team. Serves as the go to source for complex ... policies. The As a lead position, lead appeals and denial specialist this role will additional support the leads...leads the team by providing management support, when the manager is unavailable and works to developing process improvement… more
- UNC Health Care (Hendersonville, NC)
- …(RAC) Coordinator (RN) is responsible and accountable for all Care Management Denial and Recovery Audit Contractor (RAC) requests and follow-ups, including ... and denials as well as coordinating and completing the appeal process. Responsibilities: + Coordinates the Denial ...a care / case management capacity. + Certified Case Manager (CCM) as issued by the Commission for Case… more
- BronxCare Health System (Bronx, NY)
- …staff, the Appeal Manager is responsible to develop a strong appeal letter that will result in the denial being overturned providing the hospital ... the care and services provided to the patient. The Denial Manager will assist the department's leadership...staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal and… more
- Guthrie (Sayre, PA)
- …Insurance Billing Specialists I and related support staff. Works closely with Director, Manager , Supervisor and Application Analyst on day to day priorities and to ... to determine specific issues and patterns that need to be addressed. Serves on Denial Task Force(s) and assists in developing action plans to reduce denials and… more
- Molina Healthcare (WI)
- …proficiency. **Preferred Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified ... by another Molina department to reduce the likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by… more