- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The UR-CR Specialist I is primarily responsible for ensuring that patient care services are appropriately recorded and utilized in accordance with ... of care. The UR CR 1 will act as a liaison for discharge appeals and social admissions, preparing regulatory notices for delivery to the patient Minimum… more
- Trinity Health (Fort Lauderdale, FL)
- …denial coordination with Patient Business Service (PBS) centers, including analysis of clinical documentation, assisting in appeals , root cause analysis and ... including but not limited to, appending modifiers and checking clinical documentation. Works closely with Revenue Integrity staff and...tracking as needed. 6. Educates clinical staff on need for accurate and complete documentation… more
- Gentiva (Mooresville, NC)
- …Care.** We are seeking a detail-oriented and highly organized Revenue Cycle Specialist to support our billing operations through timely processing of Government and ... Benefits (EOBs) to determine next steps in payment posting or appeals . **About You** **Skills and Qualifications:** + Excellent troubleshooting and problem-solving… more
- University of Virginia (Charlottesville, VA)
- The Central Billing Office (CBO) Insurance Resolution Specialist handles and resolves all Insurance billing follow up and denial issues to ensure all facilities ... AR responsibility. Performs inpatient/outpatient follow up and working insurance denials, appeals claims as defined by payer and departmental rules. Resolves… more
- St. Luke's Health System (Boise, ID)
- …is truly a great place to work. **Overview:** The Pharmacy Benefits Specialist assists our members in identifying and navigating complex pharmacy benefits management ... of all new pharmacy benefits team members. + Review the supporting clinical documentation provided by a patient's prescriber and validate that information against… more
- Performance Optimal Health (Stamford, CT)
- …through exceptional care, service, and teamwork. We are seeking a Billing Specialist to join our growing Practice Administration/Billing team. This role combines all ... companies, patients, and internal staff. + Prepare and send appeals when claims are denied or underpaid. + Maintain...comply with HIPAA regulations. + Collaborate with the billing, clinical , and front desk teams to ensure seamless revenue… more
- Hackensack Meridian Health (Hackensack, NJ)
- …serve as a leader of positive change. The **Integrated Case Management Specialist ** performs selected services and functions related to insurance management with ... communications and support of the Care Coordinators. Prepares required Appeals and Denial information for processing and follows up...systems, ie: EPIC, INDICIA. + Educated in the unique clinical and discharge needs of the patients. + Strong… more
- Seattle Children's (Seattle, WA)
- …materials and standard procedures. Communicate coding and billing updates to clinical leaders and providers. Build and maintain strong relationships with stakeholder ... ensure coding and documentation compliance. **Required Credentials** Certified Coding Specialist -Physician Based (CCS-P) certification by the American Health Information… more
- Robert Half Accountemps (Rochester, NY)
- Description Ensure full reimbursement is received for clinical services rendered including detail oriented, long-term/home care and hospital care, by effectively and ... phone calls to the payer. Submit corrected claims and appeals . Process account adjustments and refunds as needed according...keep policies and procedures up to date with new clinical programs and payer policy changes. Acquire and maintain… more
- Geisinger (Danville, PA)
- …resource working collaboratively with a diverse group, including management, physicians, clinical and non- clinical personnel utilizing the national correct ... of prospective claim edits and partnerships. + Determines payment compliance with clinical and reimbursement policies. + Researches CPT codes to clarify coding… more