- Excelsior Orthopaedics Group (Amherst, NY)
- …CPT, ICD-10-CM, and HCPCS Level II codes for surgical and clinical procedures, ensuring accurate reimbursement, coding compliance, and efficient billing processes. ... every day. + Accurately review and abstract information from operative and clinical documentation to assign appropriate diagnosis and procedure codes for surgical… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... facilitates and tracks concurrent adverse determinations and collaborates with Appeals Management Department in managing retrospective denials. **Qualifications** +… more
- Nuvance Health (Danbury, CT)
- *Description* Summary: The Insurance Reimbursement Specialist is responsible for coordination and support of initiatives relative to the registration functions, ... referrals for service when appropriate. 2. Obtains and understands necessary clinical information (including diagnoses) for registration to initiate requests for… 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
- St. Luke's Health System (Boise, ID)
- …truly a great place to work. **Overview:** The Senior Pharmacy Benefits Specialist assists our members in identifying and navigating complex pharmacy benefits ... of all new pharmacy benefits team members. + Review the supporting clinical documentation provided by a patient's prescriber and validate that information against… more
- University of Utah Health (Salt Lake City, UT)
- …+ Resolves clinical and/or authorization denials through CARC analysis and appeals - including clinical documentation review and coordination with UR and/or ... **Employment Type** _Full-Time_ **Shift** _Day_ **Work Schedule** _Monday-Friday, 8am-4:30pm_ ** Clinical /Non- Clinical Status** _Non-Clinical_ **Location Name** _Business Services… more
- Trinity Health (Hartford, CT)
- …of occupational medicine clinic patient charges. Communicates effectively with clinical operations and administrative personnel concerning the transmission of ... medical chart documentation for the purposes of bill resubmissions and appeals . Analyzes EOB's (Explanation of Benefits) from payers to determine the accuracy of… more
- City and County of San Francisco (San Francisco, CA)
- …limited to experience: + Working with vulnerable patient populations + Supervising clinical and administrative professionals + Improving clinical quality + ... The terms of this announcement may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department of Human Resources, 1 S… more
- University of Rochester (Rochester, NY)
- …and administrative duties in a fast-paced environment in support of clinical , educational, and academic programs. Responsible for all clinic preparations, including ... preferences. Chooses and recommends among competing demands. - Examines the clinical schedule(s) on a continuous basis to identify opportunities for optimizing… 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… more