- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... to make appropriate decisions and is accountable for reviewing denials for level of care, medical necessity,...and denials for no authorization. The Senior Denials Management Specialist position communicates clinical information… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial ... functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** +...various sources ( medical records, claims data, payer medical policies, etc.), determines the causes for denials… more
- HCA Healthcare (El Paso, TX)
- …and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts ... organization that invests in you as an Inpatient Coding Denials Specialist ? At Parallon, you come first....colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- TEKsystems (Houston, TX)
- …deadlines and goals to serve their clients Skills revenue cycle appeal, revenue cycle specialist , denials specialist , appeals specialist , insurance ... EMR, EPIC, Cerner, medical billing, claims audit, appeals process, appeals letter, denials ,...follow ups Top Skills Details revenue cycle appeal,revenue cycle specialist , denials specialist , appeals … more
- TEKsystems (Austin, TX)
- Overview We are seeking a highly analytical and proactive Revenue Cycle Appeals Specialist to join our team. This role is ideal for someone with strong ... experience in appeals , denials , and insurance follow-up within the...for this temporary role may include the following: * Medical , dental & vision * Critical Illness, Accident, and… 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 ... determine appeal and grievance outcomes. + Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates... appeals and denials . + Strong verbal and written communication skills To… more
- Molina Healthcare (Austin, TX)
- …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
- Houston Methodist (Houston, TX)
- …This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the ... queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits...resolution. Engages the coding follow up team for any medical necessity or coding related appeals . +… more
- Methodist Health System (Dallas, TX)
- …to resubmit claims promptly and accurately. - Investigate and address claim denials promptly. Utilize knowledge of payor policies, medical coding guidelines, ... **Your Job** : We are seeking an experienced Accounts Receivable II (AR II) Specialist specializing in Professional Billing to join our team at our Central Business… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **42204BR** **Extended Job Title:** Prior Authorization Specialist **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for ... insurance coverage and eligibility, and obtaining required pre-authorizations for medical procedures, treatments and services. **Requisition ID:** 42204BR **Optional… more