• Denials Management Specialist

    St. Luke's University Health Network (Allentown, PA)
    …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... and rejections. + Assists in preparing reports regarding denials to include volumes, number of appeals ,...preferred. TRAINING AND EXPERIENCE: Minimum of 2-5 years of clinical nursing experience in an acute care hospital setting… more
    St. Luke's University Health Network (08/19/25)
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  • RN Clinical Review Appeals

    St. Luke's University Health Network (Allentown, PA)
    …serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, ... needed for workflow or identification of trends. Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and… more
    St. Luke's University Health Network (07/08/25)
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  • Prior Authorization and Appeals

    AscellaHealth (Berwyn, PA)
    … process. + Respond to Prior Authorization denials and submit appeals , collecting appropriate clinical support to substantiate the formal response. + ... What we are looking for Optime Care seeks a Prior Authorization and Appeals Specialist for our Berwyn, PA location. We are looking for someone who is passionate… more
    AscellaHealth (08/01/25)
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  • Coding Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... or AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and… more
    St. Luke's University Health Network (08/18/25)
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  • Revenue Cycle Management / RCM Specialist

    Option Care Health (Harrisburg, PA)
    …patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the ... payments. Assists with Billing and Collection Training and completes "second level" appeals to payers. **Job Description:** ​ Job Responsibilities: + Submits timely,… more
    Option Care Health (08/23/25)
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  • Insurance Coordinator - Corporate Patient AR Mgmt…

    Guthrie (Sayre, PA)
    Position Summary: Fulfills all requirements of an Insurance Billing Specialist II as well as identifies, analyzes and takes the necessary action to submit complex ... appeals to insurance payers. Reviews all medical chart and...CRC departments when needed, to resolve complex issues and denials through independent research and assigned projects. This position… more
    Guthrie (06/24/25)
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  • Claims and Denial Coding Analyst

    St. Luke's University Health Network (Allentown, PA)
    …clean claim submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across the network. Utilizes ... coding errors and MUE frequency for clean claim submission + Resolve coding denials through claim correction or appeal. Claim corrections will be made after review… more
    St. Luke's University Health Network (08/19/25)
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