- Southeast Georgia Health System (Brunswick, GA)
- …process in a timely manner. Demonstrates proficiency in preparation and follow-up of denial appeals . Maintains denial spreadsheet report-keeps it current & ... the key to our culture of Service Excellence. As a Resource Management Coordinator , you will conduct medical record reviews of all denied inpatient and/or… more
- Kepro (Richmond, VA)
- …for health solutions in the public sector. Acentra seeks a UM Reviewer & Appeals Coordinator RN/LCSW (Remote within Virginia) to join our growing team. Job ... in a blended role as a clinical reviewer and appeals coordinator . In the clinical reviewer role...and processes physician consultant decisions ensuring reason for the denial is described in sufficient detail on correspondence. +… 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
- Magellan Health Services (Boise, ID)
- …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
- University of Michigan (Ann Arbor, MI)
- Inpatient Coding and Appeals Coordinator - Remote Apply Now **How to Apply** A cover letter is required for consideration for this position and should be ... and experience that directly relate to this position. **Summary** The Inpatient Coding and Appeals Coordinator plays a vital role in the revenue cycle management… more
- Centene Corporation (Cheyenne, WY)
- …competitive benefits including a fresh perspective on workplace flexibility. Pharmacy Coordinator - (Grievances, Appeals , and Prior Authorizations) Remote -- ... Technician (PTCB / NHA CPhT), highly preferred Prior Authorization with Appeals experience, highly preferred. Job specific responsibilities: + Processing Pharmacy … more
- CVS Health (Phoenix, AZ)
- …Mercy Care lines of business. Required Qualifications -Research incoming electronic disputes/ appeals to identify if appropriate for unit based upon published ... Sponsor claim fiduciary responsibility, assemble data used in making the denial determination, assemble, summarize and send to Plan Sponsor contact.-Research… 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
- 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
- Athena Health Care Systems (Seymour, CT)
- Resident Care Coordinator Assistant 7 am - 3 pm, Full-Time Shady Knoll Health Center - Seymour, CT Posted 3 weeks 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
- 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
- Weill Cornell Medical College (New York, NY)
- Title: Revenue Cycle Coordinator -Revenue Integrity (Remote) Location: Midtown Org Unit: Charge Entry Work Days: Exemption Status: Non-Exempt Salary Range: $22.53 - ... billing. + Performs extensive follow-up to investigate and resolve payment denial trends. + Resolves outstanding accounts utilizing ancillary applications and… more
- The City of Houston (Houston, TX)
- …a member of the certification review committee and assist in the review of denial appeals . + Conducts pre-certification workshops and responds to public and ... Senior Business Development Coordinator Print (https://www.governmentjobs.com/careers/houston/jobs/newprint/4484787) Apply Senior Business Development … more
- BrightSpring Health Services (Columbus, OH)
- …Payee to Client Trust Fund* Responsible for working with Client Trust Fund Coordinator at the Austin* Business Center to set up RFMS Account* Assure individuals ... for each individual annually or as needed* Files Medicaid Appeals when required within 30-day time frame of decisions*...billing is complete for upload into Quickbase. Sends monthly Denial Reports to operations for any billing denied by… more
- Universal Health Services (Stuart, FL)
- …our website at https://coralshoresbehavioral.com Position Summary: The Utilization Review Coordinator Facilitates a continuum of service while promoting positive ... through coordination of patient care, daily clinical reviews, quality documentation, appeals , and reporting. + Performs timely, daily clinical reviews with all… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient ... of potential denials and respond appropriately; ie facilitate Physician to Physician appeals when appropriate and assist with construction of appeal letters. +… more
- CVS Health (Orlando, FL)
- …setting at our Patient Financial Service Centers, supporting the claims follow up, denial and appeals processes. You will directly impact a patient's life ... solutions to make health care more personal, convenient and affordable. Position Summary As a Coordinator , Revenue Cycle, you will work in a pharmacy operation… more
- Highmark Health (Harrisburg, PA)
- …requires 1 Week A Month On-Site Work This job captures all inbound appeals and grievance requests from providers and/or subscribers. The incumbent assesses the ... research such as verifying benefit coverage for the patient, denial codes, par or non-par provider status and then...calls when additional information is required. + Identify expedited appeals based on key terms/phrases. + Save medical information… more
- Highmark Health (Harrisburg, PA)
- …requirements. + Documents, monitors, intervenes/resolves and reports clinical denials/ appeals and retrospective payer audit denials. Collaboratively formulates plans ... of action for denial trends with the care coordination teams, performance improvement teams, physicians/physician advisor and third party payers. + Maintains a… more
