- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Accounts Receivable Specialist I is responsible for the billing and collection of the accounts receivable ... practitioner services for the St. Luke's Physician Group. The Accounts Receivable Specialist I is responsible for accurate and timely submission of claims to… more
- Cedars-Sinai (CA)
- **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring program ... including leading all aspects of the review for performance management and accurate coding . + Develops and supervise compliance with corrective action plans as a… more
- Emanate Health (Covina, CA)
- …in the United States, and the #19 ranked company in the country. The Denial Specialist is responsible for denial and AR management as defined by Denial Manager. The ... Denial Specialist will possess and apply thorough knowledge of collections...patient account that is involved in the audit and appeals process to accurately complete accounts receivable reconciliation. **Minimum… more
- Alabama Oncology (Birmingham, AL)
- …Business Office Summary: Under general supervision, an AR Account Follow-Up Specialist is responsible for account follow-up for all assigned accounts, resolving ... receivable current including monitoring for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take the appropriate action,… more
- Cedars-Sinai (Los Angeles, CA)
- …and provide back-up coverage. In this role you will effectively bill, submit appeals and collect monies relative to physician reimbursements. You will be in charge ... **Experience we are seeking:** + Expert knowledge of medical terminology and coding (ICD, CPT, HCPCS, Modifiers, procedure, bill type, diagnosis, and revenue codes).… 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 ... assigned. + Escalates claim issues internally to other key departments including Coding , Billing, Charging, Contracting, etc. **Knowledge / Skills / Abilities** +… more
- Lakeshore Bone & Joint Institute (Chesterton, IN)
- …completeness of documentation included with paper claims prior to submission + Initiate appeals and/or refile claims for all denials + Request refunds according to ... + Have an in-depth understanding of insurance rules and regulations, CPT/ICD10 coding information, explanation of benefits and company billing procedure(s) + Develop… more
- Independent Health (Buffalo, NY)
- …with active, current, unrestricted NYS license required; BSN preferred. Certified Coding Specialist (CCS)/AHIMA or Certified Professional Coder (CPC)/AAPC ... the collection and review of medical records specific to quality complaints/grievances and appeals as indicated in support of a high performing health plan and… more
- Community Health Systems (Franklin, TN)
- …and Certifications** + CRNP, LPN, RN, MD, PA, or DO preferred + CCS-Certified Coding Specialist required or + RHIT - Registered Health Information Technician ... denial and appeal status. + Consults with Coordinator and/or Director, Coding Denials and Appeals during any audit discrepancies. + Attends coding education… more
- LA Care Health Plan (Los Angeles, CA)
- …dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist .; submit all Grievances and Appeals response letters to ... Summary The Authorization Technician II supports the Utilization Management (UM) Specialist by handling all administrative and technical functions of the… more
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