- Avera (Brookings, SD)
- …of unpaid, overpaid/over adjusted and denied claims. + Reviews, analyzes, and appeals denials received relative to claims processing issues with insurance payers. + ... Communicates with internal and external customers involved in the claims resolution process to ensure timely claims processing.) Identifies the need to rebill claims through account review and completes claim refiling as well as submits secondary claims not… more
- Intermountain Health (Montgomery, AL)
- …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 coding for complex… more
- Monroe Community College (Rochester, NY)
- …activities and interventions, including review of Satisfactory Academic Progress appeals and targeted follow-up, assessment of student compliance with Financial ... Aid Course Eligibility (FACE), fresh start application review, and connecting with students on caseload who have withdrawn or are considering withdrawing + Report on persistence, retention, and completion objectives of assigned caseload + Connect students with… more
- New York Health Care (Valley Stream, NY)
- …necessary adjustments, while communicating these changes to the contract and filing appeals when necessary. + Correct system issues pertaining to billing, patients ... and or caregivers as directed by management. + Requirements: + Previous collections experience with proven results. + Strong analytic skills with advanced problem solving ability. + Excellent organizational skills with attention to detail. + Intermediate… more
- Trinity Health (Fort Lauderdale, FL)
- …Business Service (PBS) centers, including analysis of clinical documentation, assisting in appeals , root cause analysis and tracking as needed. 6. Educates clinical ... staff on need for accurate and complete documentation to ensure revenue optimization and integrity. Educate clinical staff on need for accurate and complete documentation to ensure revenue optimization and integrity. Perform outpatient clinical documentation… more
- Robert Half Finance & Accounting (Chicago, IL)
- …client requirements + Works closely with billing partners on bill appeals Skills/Qualifications: + Detail-oriented, with excellent organizational skills + Working ... knowledge of various Ebilling platforms, including: ASCENT, LSS, TyMetrix, Legal-X, Legal Tracker, etc. + Working knowledge of PCLaw or similar billing application + Ability to work well under pressure, ie, managing conflicting and fluctuating deadlines, and… more
- Robert Half Finance & Accounting (Mundelein, IL)
- …rates according to client requirements. + Management of timekeepers and coordinate/process appeals as required. + Ability to execute complex bills in a timely ... manner (ie, multiple discounts by matter, split billing, preparation, submission and troubleshooting of electronic bills). + Monitor outstanding Work in Process (WIP) and Accounts Receivable (AR) balances. Collaborate with billing attorneys to ensure WIP is… more
- University of Rochester (Rochester, NY)
- …edits and obtains signatures for non-routine letters of correspondence related to appeals on denied claims. This includes compiling all necessary information and ... drafts for provider signature. - Manages provider(s) documentation and information. Composes and types non routine correspondence providing factual information. - Arranges travel, conference registration and hotel accommodations. Interfaces with organizations,… more
- Avera (Sioux Falls, SD)
- …completing prior and pre-authorizations for patients insurance companies, working appeals for insurance coverage, verifying benefits, making referrals and scheduling ... pre-operative physical, and reviewing surgery information with patients. Responsible for scheduling, maintaining, and disseminating an accurate surgery schedule, including acquisition, retention, and organization of documentation, and will provide clerical… more
- Rochester Regional Health (Rochester, NY)
- …requests for cardiology medications, and monitor approvals, step therapy requirements, and appeals to ensure timely access to treatment. + Collaborate with providers ... to gather clinical documentation and assist patients with enrollment in pharmaceutical assistance programs, grants, and co-pay support. + Maintain current knowledge of manufacturer programs, eligibility criteria, and track patient enrollment and renewal… more