- NewYork-Presbyterian (Brooklyn, NY)
- …meet initial inpatient criteria or continued inpatient stay - Coordinating expedited appeals for inpatient denials with attending physicians and insurance ... providers - Ensuring organization resources are being utilized appropriately - Completing patient assessments within 24 hours - Coordinating safe and appropriate post-acute care plans - Obtains authorizations from managed care companies for post-discharge… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Denials & Appeals Coordinator is responsible for managing, tracking, and resolving denials and appeals to ensure timely ... to ensure all follow-up dates are current. + Analyzes denials to determine appropriate actions, completes appeals , or routes cases for clinical appeals as… more
- Northwell Health (Melville, NY)
- …current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness ... and intensity of services provided. + Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not… more
- Nuvance Health (Danbury, CT)
- …Business Office related to appeals , denial and clinical reviews 9. Reviews new denials and appeal upheld cases in work queue and incoming fax queue. 10. Reviews ... Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician Advisors (PAs) and other stakeholders in ensuring… more
- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ... notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the... and communicating on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care… more
- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ... notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the... and communicating on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care… more
- McLaren Health Care (Mount Pleasant, MI)
- …responsibilities of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and ... . Provides support to both internal and external customers for denial/ appeals activities and audits. Assists with monitoring and auditing activities, reviews… more
- BronxCare Health System (Bronx, NY)
- Overview Assists in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute ... action in order to improve outcomes. - Maintains an excel log related to denials / appeals activities in order to monitor successful appeals . - Assists with… more
- R1 RCM (Chicago, IL)
- …Management:** Develop, implement, and maintain comprehensive policies and procedures for denials and appeals management, ensuring compliance with industry ... sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Denials Director** , you will act as a strategic leader dedicated… more
- TEKsystems (Addison, TX)
- …processes, claim adjudication, and reimbursement methodologies. - Familiarity with insurance denials , appeals , and arbitration processes, including knowledge of ... reimbursement issues to identify the root causes. - Initiate and manage the appeals and arbitration process for denied or underpaid claims, ensuring timely and… more
