- Covenant Health Inc. (Knoxville, TN)
- …guidelines. + Provides education to auditors, nurse and coders in department relative to denials and appeals processes based on final review of denial. Escalates ... level professional internal analysis related to root cause and resolution of denials for corrective action. Work involves research and analysis of revenue cycle… 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. ... and hospital personnel to ensure qualifying diagnosis covers tests/procedures. + Analyzes denials and coordinates appeals . + Ensures corrective action is taken… more
- Baptist Memorial (Memphis, TN)
- …to send along to healthcare insurance providers in response to post-claim denials received by BMHCC. Physician Advisor communication may be necessary to provide ... the entire appeal process and determines if escalation to manager or payer is next step to get a...BMHCC contracts as it pertains to authorization and clinical denials as well as clinical audits. + Requires a… more
- Community Health Systems (Franklin, TN)
- …management policies. This role conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers ... insurance companies to secure coverage approvals and mitigate concurrent denials by submitting reconsiderations or coordinating peer-to-peer reviews. + Communicates… more
- Baptist Memorial (Memphis, TN)
- …to prevent gaps in treatment + Support BSP pharmacists to manage the appeals process for patients and ensure timely communication occurs + Understand The Centers ... claims (electronic and paper), patient statements, follow-up and resolution of nonpayment, denials , and prior authorization requests + Work timely to resolve urgent… more