- Molina Healthcare (Miami, FL)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** Responsible for reviewing and resolving... appeals and denials . + Strong verbal and written communication skills To… more
- Robert Half Accountemps (Orlando, FL)
- …with the ability to negotiate and resolve payment issues. * Knowledge of medical denials and appeals processes. * Expertise in hospital billing systems and ... accounts and resolving payment discrepancies. * Review and address medical denials , identifying root causes and implementing corrective actions. * Prepare and… more
- Ascension Health (Pensacola, FL)
- …related to coding, medical records/documentation, precertification, reimbursement and claim denials / appeals . + Assess and coordinate discharge planning needs ... with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements**… more
- HCA Healthcare (Orange Park, FL)
- …Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts assigned and apply critical thinking skills to ascertain ... organization that invests in you as an Inpatient Coding Denials Specialist? At Parallon, you come first. HCA Healthcare...difference. We are looking for a dedicated Inpatient Coding Denials Specialist like you to be a part of… more
- HCA Healthcare (Port St. Lucie, FL)
- …pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, discharge planning, case management, and utilization ... case managers and hospital staff in the reduction of payer denials and in the denial and appeals process, as requested by the Case Management Department and… more
- Cardinal Health (Tallahassee, FL)
- …in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + ... Processes denials & rejections for re-submission (billing) in accordance with...changes that may need to be made. + Processes denials & rejections for re-submission (billing) in accordance with… more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that require… more
- Molina Healthcare (FL)
- …by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal into information system and prepares documentation ... systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. +… more
- TEKsystems (Tampa, FL)
- …and report documentation trends, coding errors, or compliance risks. * Assist with appeals and denials related to coding or medical necessity. * Maintain ... current knowledge of coding updates, payer policies, and compliance regulations affecting ASC services. * Support coding audits and implement feedback from quality reviews. * Monitor and respond to payer coding updates or regulatory changes relevant to ASCs. *… more
- Akumin (West Palm Beach, FL)
- …imaging procedures from insurance companies. Provides supporting documentation for all insurance appeals and denials . + Other duties as assigned. **Position ... Requirements:** + High School Diploma or equivalent experience. + CPR Certification. + 1 year in medical/hospital setting + **Interpersonal Skills:** Relationship building skills to work with all functional units of the organization effectively. Experience in… more