- University of Southern California (Alhambra, CA)
- …federal & state coding compliance regulations and guidelines, the HIM Coding Denials Management Specialist " analyze, investigate, mitigate, and resolve all ... denials , triage denied claims to distinguish coding-related denials versus clinical -related denials , evaluating...will provide guidance and training to other HIM Coding Denials Management Specialist , and will assist with… more
- Stanford Health Care (Palo Alto, CA)
- …in the Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials . This position ... skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with ...regulations, payor policies, and industry best practices related to clinical appeals and denials management.… more
- University of Southern California (Arcadia, CA)
- …Documentation Improvement Practitioner (CDIP) certification status preferred. + Certified Clinical Documentation Specialist (CCDS) credential preferred. Pay ... recommendations on query structure, process, and workflow. Responds to coding denials with clinical justifications and coding conventions. Maintain… more
- UCLA Health (Los Angeles, CA)
- …statuses, tracking cases and maintaining updated records in various systems + Review claim denials for clinical issues, prepare appeals , and manage each ... and quality in claim processing. As an Audit and Appeals Specialist , you will: + Facilitate responses...knowledgeable, detail-oriented professional with: + Bachelor's degree in a clinical or related field, or equivalent training and experience… more
- Sharp HealthCare (San Diego, CA)
- …with appropriate clinical staff the status of ongoing payer requests, denials and/or potential denials for non-covered services and other problems; initiate ... communication with appropriate agencies and clinical staff for appeal of denials ; Conduct...team to communicate changes in pre-authorization, denial, medical review, appeals , managed care contracts, and referrals to ensure timely… more
- Ventura County (Ventura, CA)
- …rate, compliance rate with quality standards and HCAI requirements; + Reviews insurance denials and submit appeals as necessary, provide education to coders ... based on denials ; + Assists in organizing, coordinating, and directing of...Coders (Inpatient & Outpatient), coding productivity and collaborate with Clinical Documentation Specialist team; + Provides coding… more