- Trinity Health (Farmington Hills, MI)
- …Responsible for reviewing all post-billed denials (inclusive of clinical denials ) for medical necessity and appealing them based upon clinical ... Payment Resolution with communication and follow-up processes related to rejections, denials and appeals , ensuring that such activities are tracked,… more
- Trinity Health (Farmington Hills, MI)
- …activities as part of the payment resolution team that receives, analyzes, and appeals denials received for an assigned PBS location. Reviews, researches and ... Performs day-to- day payment resolution activities within the Hospital and/or Medical Group revenue operations ($3-5B NPR) for an assigned Patient Business… more
- Sanford Health (Sioux Falls, SD)
- …of documentation, interpretation of policies, and handling of correspondence related to denials and appeals submitted by providers and members. Must administer ... a demonstrated understanding of regulatory requirements and timeframes. Intake and coordinate appeals and denials , and then make determinations based on member… more
- TEKsystems (Plano, TX)
- Required: + 2+ years of Insurance follow-up, denials / appeals experience ( Medical A/R) + Hospital/facility collections experience Description: Responsible for ... to increase efficiency of collections. * Responsible for timely medical records requests and submission of appeals ...timely medical records requests and submission of appeals * Maintain adequately trained staff to achieve daily… more
- Fairview Health Services (St. Paul, MN)
- **Overview** The Physician Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by the ... pertaining to billing, coding, and documentation. The Physician Coding Denials Specialist will also handle audit-related and...appeals or re-billing of claims to resolve coding denials to ensure collection of expected payment and mitigation… more
- Robert Half Accountemps (Cincinnati, OH)
- …We are offering a unique opportunity in the healthcare industry for a Denials Specialist located in Cincinnati, Ohio. This role involves reviewing and ... * Minimum of 3 years of experience as a Denials Specialist or in a similar role... * Ability to write effective appeal letters for medical appeals * Strong understanding of … more
- Rush Copley Medical Center (Aurora, IL)
- **Position Summary** : The Appeals Specialist RN reviews inpatient hospital denials , clinical validation requests, and upheld denials after ... to details, and self-motivated. **Experience** + Knowledge/experience in utilization management, denials and/or appeals management in hospital or physician … more
- SSM Health (MO)
- …Responsibilities and Requirements:** Job Description PRIMARY RESPONSIBILITIES + Composes DRG/APC appeals based on medical record documentation, coding guidelines ... seeking a highly skilled and detail-oriented Coder for Hospital Denials to join our team at SSM Health. You...at SSM Health. You will be responsible for reviewing medical records and accurately coding diagnoses and procedures for… more
- Universal Health Services (Richmond, VA)
- …The Atlantic Region CBO is seeking a dynamic and talented Senior Appeals Specialist . The Senior Appeals Specialist ... billing of claims and the follow-up on the clinical appeals performed by the facilities. Key Responsibilities include: +...Competitive Compensation & Generous Paid Time Off + Excellent Medical , Dental, Vision and Prescription Drug Plans + 401(K)… more
- HCA Healthcare (Nashville, TN)
- …**Introduction** Do you want to join an organization that invests in you as an Appeals Specialist ? At Parallon, you come first. HCA Healthcare has committed up ... make a difference. We are looking for a dedicated Appeals Specialist like you to be a...arguments for reconsiderations. Identify contract protection to leveraged overturn denials . Argue appeals that prevent claim payment… more
- Universal Health Services (Bonham, TX)
- …TMC Bonham is managed by Texoma Medical Center, subsidiary of UHS. The Appeals Specialist is responsible for appealing all insurance denials and prepare ... payers in compliance with Managed Care contracts and government fee schedules. The Appeals Specialist will obtain, manipulate, and analyze data from a variety… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES & ESSENTIAL JOB...reflect the standard of care, as defined by the medical staff and the organization; utilizes clinical knowledge and… more
- St. Luke's University Health Network (Allentown, PA)
- …for health care. The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding ... related claim denials for professional services, FQHC, MSO, and ASCs across...documentation and queries, coding software tools and Insurance carrier medical and reimbursement policies during the claim review process.… more
- University of Virginia (Charlottesville, VA)
- …analyzes accounts receivable and takes appropriate action to resolve coding and global denials . + Posts denials /rejects into EPIC billing system. + Works complex ... required. Experience in insurance field preferred. Experience utilizing EPIC or other medical billing system required. Licensure: CPC required or two years of… more
- Johns Hopkins University (Baltimore, MD)
- …resolve issues and facilitate prompt payment of claims. Communicates with providers regarding appeals and medical policy denials , and provides appropriate ... We are seeking a **_PB_** **_AR Revenue Cycle Specialist III_** responsible for the collection of unpaid...specialized, complex or high-cost procedures. + Contacts providers regarding appeals and medical policy denials ,… more
- Hartford HealthCare (Farmington, 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...management or finance. *Experience* . Minimal: 2 -4 years medical billing and/or accounts receivables experience in a facility… more
- Hackensack Meridian Health (Hackensack, NJ)
- …information for appeals of Managed Care audits, clinical and technical denials by utilizing various Epic and legacy systems for Hackensack Meridian Health (HMH) ... as a leader of positive change. The **Appeal Nurse Specialist ** will be responsible for the timely review and...Facilitates payer audit requests, ie Equiclaim, RAC, etc. for medical necessity denials . + Participate in all… more
- Beth Israel Lahey Health (Burlington, MA)
- …Billing Office. 15. Independently works on the resolution of complex claims issues, denials and appeals . 16. Completes projects and research as assigned. 17. ... **Work Shift:** Day (United States of America) 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
- Universal Health Services (Wayne, PA)
- …- Independence Physician Management - UHS. Position Overview The Accounts Receivable Specialist is responsible for the accurate and timely follow-up of unpaid and ... criteria to meet or exceed collection targets and minimize write-offs. Researches claim denials by assigned payer/s to determine reasons for denials correcting… more
- Beth Israel Lahey Health (Burlington, MA)
- …15. Assists the Billing Supervisor with the resolution of complex claims issues, denials and appeals . 16. Completes projects and research as assigned. 17. ... Identifies, reviews, and interprets third party payments, adjustments and coding denials for all professional services. Reviews provider documentation in order to… more