- Community Health Systems (Franklin, TN)
- …the denial and appeal status. + Consults with Coordinator and/or Director, Coding Denials and Appeals during any audit discrepancies. + Attends coding education ... quality monitoring and evaluation of work products by the Coordinator and/or Director, Coding Denials and Appeals . + Partners with peers and Director to develop… more
- HCA Healthcare (Nashville, TN)
- …opportunity. We want your knowledge and expertise! **Job Summary and Qualifications** The Clinical Denials Coding Review Specialist is responsible for ... **Introduction** Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want...as it relates to researching, analyzing, and resolving outstanding clinical denials and insurance claims. This job… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... management policies. This role conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers… more
- Covenant Health Inc. (Knoxville, TN)
- …Business Office personnel to resolve issues related to claims, coding, pre-cert, and denials appeals , and verifies that appropriate chargemaster rates are used. ... Overview Coding Specialist , Centralized Coding, Outpatient Coder Full Time, 80...personnel to ensure qualifying diagnosis covers tests/procedures. + Analyzes denials and coordinates appeals . + Ensures corrective… more
- Community Health Systems (Franklin, TN)
- …and reduce potential denials , utilizing input from the Utilization Review Clinical Specialist . + Monitors and updates case management software with ... ensures efficient and effective management of utilization review processes, including denials and appeals activities. This role collaborates with payers,… more
- BrightSpring Health Services (Nashville, TN)
- …the month for assigned Operations. + Timely follow up on insurance claim denials , exceptions, or exclusions. + Maintain open communication with Billing Specialist ... patients, and providers. + Works in Waystar to identify denials and timely resolution. + Timely follow up of...Billing Portal sites, preferred. + Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement… more