- Molina Healthcare (Akron, OH)
- …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
- Molina Healthcare (OH)
- …for letters and prepare responses to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial ... by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal into information system and prepares documentation… more
- KPH Healthcare Services, Inc. (Maumee, OH)
- **Overview** The Revenue Cycle Management Specialist - Collections responsibility is to ensure timely collection of outstanding balances. **Responsibilities** + ... complex or uncollectible accounts to management for further action. + Submit appeals /claim corrections as needed within timely filing limits. + Utilize billing… more
- Intermountain Health (Columbus, OH)
- …levels, providers, clinical staff, compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades and provides ... in-depth coding review, audit findings, and appeal strategies. + Develops and implements training plans for all internal stakeholders including coders at all levels, providers, clinical staff, compliance and the CDI team. + Audits clinical documentation and… more
- ProMedica Health System (Toledo, OH)
- …billing changes to ensure appropriate reimbursement. 7. Conducts reviews of coding denials or other payer requests; performs appropriate follow up including ... appeals and corrective actions with departments and staff. 8. Assist in reviewing and updating physician documentation templates and forms consistent with… more
- Cardinal Health (Columbus, OH)
- …in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + ... prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and...Processes denials & rejections for re-submission (billing) in accordance with… more