- UNC Health Care (Kinston, NC)
- …Reviews all denial requests and leads the team in the strategy to appeal all clinical denials . Provides the clinical expertise to draft the first and ... to reimbursement, denials , status, etc. 6. Evaluates clinical denials for validity and probability to...win rates. 12. Assists in documentation review in the clinical documentation specialist role when needed. Working… more
- Community Health Systems (Franklin, TN)
- … Documentation Improvement Professional required or + CCDS - Certified Clinical Documentation Specialist required Equal Employment Opportunity This organization ... **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits...for accuracy in ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This includes evaluating present on admission (POA)… more
- Nuvance Health (Danbury, CT)
- …5-9pm- Rotate Weekends/Evenings* *Summary:* Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician ... with the System Business Office related to appeals, denial and clinical reviews 9. Reviews new denials and appeal upheld cases in work queue and incoming fax… more
- Texas Health Resources (Arlington, TX)
- …with a top-notch health care company? We're looking for a qualified_ Coder II ( Denials ) _like you to join our Texas Health family._ Position Highlights + Work ... Certified Professional Coder Upon Hire REQUIRED or CCS-P - Certified Coding Specialist - Physician-based Upon Hire REQUIRED and Other Specialty certification such as… more
- Rochester Regional Health (Rochester, NY)
- …resolve the issues resulting in denial/underpayment and to formally appeal. The specialist will conduct comprehensive reviews of clinical documentation to ... SUMMARY The C & D specialist is responsible for reviewing accounts which have...claims processing and accounts receivable collections. The Medical collection specialist must have the Ability to learn and understand… more
- Stanford Health Care (Palo Alto, CA)
- …States of America) **This is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist II plays a critical role ... in the Revenue Cycle Denials Management Department by managing and resolving ...as well as excellent analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist … more
- University of Southern California (Arcadia, CA)
- …Documentation Improvement Practitioner (CDIP) certification status preferred. + Certified Clinical Documentation Specialist (CCDS) credential preferred. Pay ... recommendations on query structure, process, and workflow. Responds to coding denials with clinical justifications and coding conventions. Maintain… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data ... DUTIES AND RESPONSIBILITIES: + Conduct retrospective medical record reviews for clinical validation of diagnosis and procedure code assignment and MS-DRG/APR-DRG… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital… more
- Henry Ford Health System (Troy, MI)
- …SUMMARY: Reporting to the Manager, Revenue Integrity, the Revenue Integrity Specialist identifies revenue opportunities and works collaboratively with Revenue Cycle ... staff to drive process improvement, educate clinical departmental staff, and document workflows. Primary areas of focus include revenue capture accuracy, decreased … more