- St. Luke's University Health Network (Allentown, PA)
- …and/or formal meetings with auditor or payor representatives in defense of coding appeals , as needed. + Maintain necessary audit/appeal activity documents ... patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient...for outpatient/CPT payor recommendations in collaboration with the OP Coding Supervisor or Network Coding … more
- Ventura County (Ventura, CA)
- Certified Coding Supervisor - Health Information Management Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4892159) Apply Certified ... Coding Supervisor - Health Information Management Salary...for the Health Information Management (HIM) department related to coding and CDI ( clinical documentation improvement). The… more
- UNC Health Care (Chapel Hill, NC)
- … coding denials and appeals on both inpatient and outpatient cases. Reviews coding insurance denials and refers clinical coding denials to the CDI ... into shared services. This position reports to the HCS Supervisor Coding and CDI Quality and Training.... and send for rebilling if required. 5. Generate coding appeals for insurance denials with sound… more
- Covenant Health Inc. (Knoxville, TN)
- …procedures relative to coding . + Educates and assists physicians and clarifies coding versus clinical issues. + Works closely with Registration and Business ... Office personnel to resolve issues related to claims, coding , pre-cert, and denials appeals , and verifies that appropriate chargemaster rates are used. + Reviews… more
- HCA Healthcare (San Antonio, TX)
- …payer websites + Escalates problem accounts/processes/trends and report opportunities to supervisor for denial prevention and coding education opportunities + ... III (CARS-III) duties + Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical /medical resources… more
- Guthrie (Sayre, PA)
- …all medical chart and account documentation in order to determine appropriate coding and initiate corrected claims and appeals . Interprets payer guidelines, ... HCPCS, modifier and linkage. 3. Initiates complex appeal procedures and submits appeals for billing resolution by utilizing proficient coding skills. Works… more
- Houston Methodist (Houston, TX)
- …in resolution. Engages the coding follow up team for any medical necessity or coding related appeals . + Assures accounts are completed and worked at a high ... required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the professional fee environment. This… more
- Houston Methodist (Houston, TX)
- …appropriate billing functions, including claims resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for any ... medical necessity or coding related appeals . **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Stays current on collection procedures of various payors and industry… more
- Peak Vista (Colorado Springs, CO)
- …and certifications that are essential to the position. + Perform self-audits and reviews/corrects Coding Supervisor audit reports to maintain a 95% coding ... clinical documentation and how it relates to medical coding , coding guidelines and payer rules. Essential...+ Provides expertise to Accounts Receivable Staff in addressing appeals for denials due to potential coding … more
- Cedars-Sinai (Torrance, CA)
- …and resolve denied or underpaid claims; prepare and submit timely, accurate written appeals with supporting clinical / billing documentations in accordance with ... may act in the absence of the lead and/or supervisor . This position may be cross-trained in other revenue...including progress notes, lab results, pathology reports, and other clinical records, to support accurate billing, appeals ,… more