- 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
- Datavant (Nashville, TN)
- …realize our bold vision for healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of ... recognized medical necessity criteria and standards of care, along with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed… more
- Community Health Systems (Franklin, TN)
- … Documentation Improvement Professional required or + CCDS - Certified Clinical Documentation Specialist required Equal Employment Opportunity This organization ... **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits...for accuracy in ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This includes evaluating present on admission (POA)… 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 ... collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Clinical Documentation Integrity Specialist , Clinical Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the ... the appropriate assignment of a final DRG. The CDI Specialist functions as a resource for clinical ...Monitors activities and findings with regard to audits and denials and subsequently adjusts to potential trends when reported.… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Clinical Documentation Integrity Specialist Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is East Tennessee's ... the appropriate assignment of a final DRG. The CDI Specialist functions as a resource for clinical ...Monitors activities and findings with regards to audits and denials and subsequently adjusts to potential trends when reported.… more
- Community Health Systems (La Follette, TN)
- **Job Summary** The Medicare Billing Specialist is responsible for performing timely and accurate Medicare billing activities, including claims preparation, ... validation, and documentation review. This role collaborates with revenue cycle teams, clinical departments, and external payers to ensure claims are submitted in… more
- WestCare Foundation (Dandridge, TN)
- …Level High School Description Position Summary: The Billing and Credentialing Specialist is responsible for overseeing insurance billing processes, managing provider ... in the allocation of funds. + Denial Management: Review and analyze claim denials , identify the reasons for denial, and take appropriate action to correct and… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Coding Specialist , Centralized Coding, Outpatient Coder Full Time, 80 Hours Per Pay Period, Day Shift inpatient Covenant Health Overview: Covenant Health is ... serves as the user advocate between Health Information Management (HIM), Clinical Effectiveness, and Registration. Other job duties include: improving health record… 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, hospital… more