- Sanford Health (SD)
- …Commercial Carrier workflows related to daily coding and denial review and appeals management, including the preparation of supporting documents and information to ... accurate and timely international classification of disease - tenth edition - clinical modification (ICD-10) - CM coding of diagnoses, Healthcare Common Procedure… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …the VP Pharmacy for performance on pharmaceutical spending targets, and the clinical team for population management. STRATEGICE PLANNING AND PROCESS IMPROVEMENT: + ... distribution, accurate provider directories, performance on VBC contracts, benefit adjudication, appeals , and grievances. + Collaborate with the TPA to understand… more
- The County of Los Angeles (Los Angeles, CA)
- …in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the ... disaster/emergency services, when required. Regional Disaster Medical and Health Specialist Program (RDMHS) Assists in the development, implementation, and… more
- Bristol Myers Squibb (Tampa, FL)
- …for escalation and resolution of Tier 2 queries, plan interpretation and appeals . + Responsible for ensuring internal processes are documented and updated versions ... Workday, ServiceNow, ADP and vendor management. + Certified Employee Benefits Specialist (CEBS) or equivalent Industry designation, preferred. \#LI-Hybrid If you… more
- Rochester Regional Health (Rochester, NY)
- …the medical management department in the tracking, trending and reporting of appeals and charge recovery information. + Conducts reviews of cost outliers and ... Provides ongoing support for the tracking and trending of the Reimbursement Specialist charge recovery activities. + Assists with special projects including but not… more
- Methodist Health System (Dallas, TX)
- …Manager in this role is responsible for of the oversight of 16-20 AR Specialist and a Team Lead. Setting and achieving performance goals by fostering teamwork, ... and maximum reimbursement for multi-specialty physician services. + Directs the appeals and reconsideration process, including root cause analysis, persuasive appeal… more
- BrightStar Care (Naples, FL)
- …We are looking for the an experienced medical Billing and Payroll Specialist . Responsibilities include weekly processing of billing and payroll.. Managing ... Authorizations , appeals and re- submission of claims . Posting cash...Medical * Dental * Vision * Mileage Reimbursement for clinical / administrative positions * Employee Assistance Program *… more
- AdventHealth (Tampa, FL)
- …Research Institute, also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience, cardiovascular medicine, ... analyze claim denials to perform the appropriate resolution, rebilling, and/or appeals steps. Assists with developing and implementing strategies and procedures to… more
- St. Luke's University Health Network (Allentown, PA)
- …CCI/LCD, carrier policy and utilization of coding software applications. The appeals process may include collaboration with the Claim Editing Manager, Physician, ... Specialty Coder, AR specialist or Auditor/Educator. Demonstrate the ability to formulate an...the ability to formulate an appeal rationale based on clinical documentation, application of LCD, relative carrier policy and… more
- BrightSpring Health Services (Valdosta, GA)
- …Complete revenue balancing and reporting.* Maintain open communication with Billing Specialist , Cash Application Analyst and Operations.* Send cash transfer & check ... with State Billing Portal sites, preferred.* Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement preferred*… more