- St. Luke's University Health Network (Allentown, PA)
- …and/or formal meetings with auditor or payor representatives in defense of coding appeals , as needed. + Maintain necessary audit/appeal activity documents ... patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient...for outpatient/CPT payor recommendations in collaboration with the OP Coding Supervisor or Network Coding … more
- Guthrie (Sayre, PA)
- …all medical chart and account documentation in order to determine appropriate coding and initiate corrected claims and appeals . Interprets payer guidelines, ... HCPCS, modifier and linkage. 3. Initiates complex appeal procedures and submits appeals for billing resolution by utilizing proficient coding skills. Works… more