- CenterWell (Austin, TX)
- …responding to, managing and monitoring all payer requests for additional documentation (ADR), appeals and denials . Works with branch staff to gather required ... to develop appropriate and timely responses. + Responsible for constructing response to denials and appeals , utilizing any federal guidelines or local coverage… more
- Houston Methodist (Houston, TX)
- …coding staff; and functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** + Communicates openly in a ... At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial… more
- Texas Health Resources (Arlington, TX)
- …and providers related to issues identified with root cause analysis of the denials and appeals process Manage/Troubleshooting for high priority clinics as ... **Manager Billing Coding and Denials ** _Are you looking for a rewarding career...work hours: Monday-Friday 8:00a-5:00p **Summary** The Billing, Coding & Denials Manager will oversee all aspects of claim review… more
- Molina Healthcare (Fort Worth, TX)
- …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** **Job Summary** Responsible for reviewing... appeals and denials . + Strong verbal and written communication skills +… more
- Molina Healthcare (TX)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine Provider No Surprises Act… more
- Houston Methodist (Sugar Land, TX)
- …processes, managed care contracts and coordination of benefits related to coverage, clinical appeals , and denials to include knowledge of CPT and ICD codes ... At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing...review activities, and monitoring the clinical denial management and appeals process, as applicable, in collaboration with clinical team… more
- Houston Methodist (Houston, TX)
- …services. This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in ... payer work queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits appeals when necessary. + Resolves… more
- Caris Life Sciences (Irving, TX)
- …and genetic testing services. This role is responsible for overseeing appeals processes associated with denials from Caris-contracted and non-contracted ... Life Sciences is seeking an experienced and strategic Director of Billing Operations - Appeals to lead the appeals management function for an assigned payor… more
- Houston Methodist (Katy, TX)
- …to: medical coding, insurance billing, collections, patient account resolution, appeals / denials , customer service, cash applications, revenue integrity, etc. ... but not limited to the following: accounts receivable days, cash collections, denials , avoidable write-offs, staff productivity and work quality and credit balances.… more
- Houston Methodist (Houston, TX)
- …on insurance/managed care benefits + Supports and assists with concurrent insurance denials and appeals process, transmission of utilization reviews to insurance ... directed by the clinical team. Documents authorization, approvals, and denials **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Maintains awareness of payor/reimbursement… more