- Dayton Children's Hospital (Dayton, OH)
- …Home - OhioDepartment:Utilization Review TeamSchedule:Full timeHours:40Job Details:Reporting to the Manager of Utilization Management and in partnership with the ... and Resource Management; supports the development and implementation of a comprehensive denials management program. This role functions as a hospital liaison with… more
- Hartford HealthCare (Farmington, CT)
- …of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials , ... validation denials . This role involves validating the coding and clinical accuracy, ensuring proper documentation, and collaborating with other departments to… more
- Beth Israel Lahey Health (Plymouth, MA)
- … denials . + Responsible for appeals and follow up on clinical denials escalated through a work queue, providing appropriate response supported by ... people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who...UR and the analysis, resolution, monitoring & reporting of clinical denials . + Maintains current knowledge of… more
- TEKsystems (Annapolis, MD)
- … clinical denials . This staff member reviews all initial clinical denials to determine next steps and conducts appeals as appropriate, such as by ... The clinical denial appeals specialist also works to prevent future clinical denials by communicating with clinical and revenue cycle leadership… more
- St. Luke's University Health Network (Allentown, PA)
- …to, physicians, hospital employees and vendors. Advises Network CDI & DRG Denials Manager on issues requiring immediate attention. ADDITIONAL REQUIREMENTS: ... regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of… more
- Garnet Health (Middletown, NY)
- …is responsible for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate ... The Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials … more
- Genesis Healthcare (York, PA)
- …to reduce AR/DSO and outstanding clinical accounts as needed and generates clinical appeals when necessary. 15. Assists with and completes special projects ... while making a meaningful impact in the communities we serve. Responsibilities The Manager , Case Management is responsible for the clinical , administrative, and… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …high volume, dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and ... Clinical Authorization Specialist is also responsible for managing denials related to front-end prior authorization, biosimilar drugs, pharmacy-benefit exclusion… more
- LifePoint Health (Rutherfordton, NC)
- …payer guidelines and financial implications of discharge plans.5. Follows up with any denials through the appeals process; including RAC chart audit reviews. ... **Please select a valid job field* **Organization:** ** **Title:** * Clinical Case Manager * **Location:** *NC-Rutherfordton* **Requisition ID:** *7462-9861* more
- Trinity Health (Nampa, ID)
- …and the highest quality of care. We are looking to hire a ** Clinical Resource Manager ** for our Medical Center in Nampa, Idaho ... that can't be beat. **About this position:** As a Clinical Resource Manager you will provide concurrent...by third party payers and Medicaid. + Responsible for appeals , denials , as appropriate. Utilizes physician advisor… more
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