- Locations: California, Texas, Massachusetts, Florida, Washington
- Related Keywords: Appeals, Denial, Denial Appeals Manager, Hospital Denial Appeals
- Abstractor/Coder
- The University of Chicago (Burr Ridge, IL)
- ...reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses and physician visits. Analyze denial and rejection reports and appeals whenever appropriate. Provide information and direction to the physicians relevant to coding. Submit charges to...
- Denial / Appeals Spec
- Presbyterian Health Services (Albuquerque, NM)
- DENIAL / APPEALS SPEC Requisition Number: 29194 Location: NM - Albuquerque Type of Opportunity: Regular Full-Time FLSA Classification: NON-EXEMPT Minimum Experience: 2 years Minimum Education: High School Degree or Equivalent Shift: Days Minimum Skills/Requirements High school degree or...
- Denial / Appeals Spec
- Presbyterian Health Services (Albuquerque, NM)
- DENIAL / APPEALS SPEC Requisition Number: 29194 Location: NM - Albuquerque Type of Opportunity: Regular Full-Time FLSA Classification: NON-EXEMPT Minimum Experience: 2 years Minimum Education: High School Degree or Equivalent Shift: Days Minimum Skills/Requirements High school degree or...
- System Director, Clinical Denial Management
- Holy Family Medical Center (Des Plaines, IL)
- ...to respond to denials and RAC audits. Advises RHC facilities and other providers on the resources necessary to effectively manage the denial appeals . Develops and maintains policies & procedures specific to denial management and denial prevention. Audits the process...
- System Director, Clinical Denial Management
- Resurrection Health Care (Des Plaines, IL)
- ...to respond to denials and RAC audits. Advises RHC facilities and other providers on the resources necessary to effectively manage the denial appeals . Develops and maintains policies & procedures specific to denial management and denial prevention. Audits the process...
- Clinical Denial Appeal Nurse - Clinical Denial Appeal Nurse
- Valley Presbyterian Hospital (Van Nuys, CA)
- ...with intent to prove measurable decline in insurance denials and underpayments. Collaborates with collection staff about denial reasons, appeals and their outcomes, medical necessity, and managed care contractual requirements.CA Registered Nurse License required. Bachelor's degree...
- Clinical Denial Appeal Nurse
- Valley Presbyterian (Van Nuys, CA)
- ...accounts with intent to prove measurable decline in insurance denials and underpayments. Collaborates with collection staff about denial reasons, appeals and their outcomes, medical necessity, and managed care contractual requirements. CA Registered Nurse License required. Bachelor's...
- Certification Manager
- Complex Staffing Solutions (Arlington, TX)
- ...questions about the certification process from callers and emails throughout the certification process from initial applications to certification, and denial appeals . 3. Prepare agenda for certification committee meetings; track status of each applicant file; compose list of files to...
- Director Social Work Care Coordination -- Baylor Regional Medical Center -- Grapevine -- Days
- Baylor Health Care System (Grapevine, TX)
- ...2. Evaluates appropriateness of discharge referrals/placements. 3. Reviews denial information trends with the Business Office. 4. Assigns denial appeals . 5. Modifies discharge placement patterns to ensure optial patient outcomes. 6. Uses criteria and physician director to determine...
- Clinical Care Coordinator
- WVU Healthcare (Morgantown, WV)
- ...and submits written appeal within the payors required ? Appeal timeframe with assistance from Care Management Medical Director. ? Ensures denial and appeals are tracked and trended and reports to Director Care Management. ? Assists acute Clinical Care Coordinator with DC planning of...
- Appeals Administrator II
- The SCOOTER Store (New Braunfels, TX)
- ...recommendations for appeals arguments coordinating with the Supervisor of Appeals and the Medicare Appeals Officer. Reviews each denial /appeal for proper billing, compliance to all Medicare regulations and ensures that documentation provides support for medical necessity....
- Utilization Management Specialist
- Covenant HealthCare (Saginaw, MI)
- ...to third party payer reviews. Education Licensure Certification: RN with current license in State of Michigan required Experience Required: 3 years successful performance in utilization management required Demonstrates competence in denial appeals management and utilization management
- Clinical Denial Appeal Nurse
- Valley Presbyterian (Van Nuys, CA)
- ...accounts with intent to prove measurable decline in insurance denials and underpayments. Collaborates with collection staff about denial reasons, appeals and their outcomes, medical necessity, and managed care contractual requirements. CA Registered Nurse License required. Bachelor's...
- Utilization Review
- Caritas Christi (Dorchester, MA)
- ...monitoring/assuer appropriate level of care. Entering OBS charges including ED cases. Manage all managed care denials and appeals - includes denial avoidance activities. Management of Medicare and Mass Health pre/post payment reviews. Retrospective/weekend reviews and securing third...