- Beth Israel Lahey Health (Plymouth, MA)
- … denials . + Responsible for appeals and follow up on clinical denials escalated through a work queue, providing appropriate response supported by ... people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who...UR and the analysis, resolution, monitoring & reporting of clinical denials . + Maintains current knowledge of… more
- CenterWell (Boston, MA)
- …responding to, managing and monitoring all payer requests for additional documentation (ADR), appeals and denials . Works with branch staff to gather required ... to develop appropriate and timely responses. + Responsible for constructing response to denials and appeals , utilizing any federal guidelines or local coverage… more
- Beth Israel Lahey Health (Plymouth, MA)
- …concurrent and retrospective reviews for level of care and continued stay * Lead appeals of clinical denials and collaborate with physician advisors * ... - Utilization Review & Denials Management** This role is ideal for a Manager with strong clinical knowledge, leadership skills, and a passion for innovation… more
- Children's Hospital Boston (Boston, MA)
- …authorizations for the appropriate level of care for admissions and with post-discharge appeals of payer denials . They identify and implement initiatives to ... 80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care OperationsAutoReqId:80451BRStatus:Part-TimeStandard Hours per… more
- Beth Israel Lahey Health (Burlington, MA)
- …Manages UM department in the context of other Revenue Cycle functions such as Denials & Appeals , Patient Access, Authorization Management & review, HIM, Coding & ... and reviews staff schedules and workflows and works closely with other administrative and clinical areas under the direction of the Executive Director and the VP of… more
- Beth Israel Lahey Health (Plymouth, MA)
- … clinical knowledge with billing knowledge to review, evaluate, and appeal clinical denials related to the care provided to the hospitalized patient. ... to assess and improve the denial management, documentation, and appeals process. + Collaborates with UR Manager ...degree in healthcare preferred. + Three years recent, broad clinical experience in the hospital setting + Experience with… more