- Sharp HealthCare (La Mesa, CA)
- …with providers.Provide advice to Revenue Cycle/HIM regarding RAC decision to appeal, denials , input into appeals , share findings with providers.Review all cases ... organization goals including reductions in length of stay, decreasing denials , improvement of care transitions, and reduction in avoidable readmissions,… more
- Ventura County (Ventura, CA)
- …rate, compliance rate with quality standards and HCAI requirements; + Reviews insurance denials and submit appeals as necessary, provide education to coders ... based on denials ; + Assists in organizing, coordinating, and directing of coding activities of the Health Information Management Department at VCMC; + Reviews and… more
- Sharp HealthCare (San Diego, CA)
- …with providers.Provide advice to Revenue Cycle/HIM regarding RAC decision to appeal, denials , input into appeals , share findings with providers.Review all cases ... organization goals including reductions in length of stay, decreasing denials , improvement of care transitions, and reduction in avoidable readmissions,… more
- MVP Health Care (Rochester, NY)
- …Monitor service utilization to maintain cost-effectiveness and manage Medical Loss Ratio (MLR). + Appeals & Denials : Participate in the appeals process for ... denied services and ensure timely resolution. + Training & Support: Educate staff and providers on UM protocols, documentation standards, and clinical guidelines. + Contribute to our humble pursuit of excellence by performing various responsibilities that may… more
- UNC Health Care (Kinston, NC)
- …all denial requests and leads the team in the strategy to appeal all clinical denials . Provides the clinical expertise to draft the first and second levels of an ... the Physician Advisors and subject matter experts for all audit and appeals work activities. Assists with documentation review to support the clinical documentation… more
- University of Southern California (Alhambra, CA)
- …& state coding compliance regulations and guidelines, the HIM Coding Denials Management Specialist" analyze, investigate, mitigate, and resolve all coding-related ... 'claims denials ' and 'claims rejections,' specific to ICD-10-CM, ICD-10-PCS, CPT/HCPCS,...appeal. Performs all 1st and 2nd level coding-related denial appeals . All tasks & duties to be perform in… more
- Cardinal Health (Washington, DC)
- …receivables performance and client satisfaction. + Resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. ... including all Medicaid states on paper and online. + Oversees appeals and denials management to maximize revenue recovery and minimize financial leakage,… more
- Fairview Health Services (St. Paul, MN)
- …and submitting appropriate appeals or re-billing of claims to resolve coding denials to ensure collection of expected payment and mitigation of denials ; + ... **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts to ensure receipt...records and coding guidelines to formulate coding arguments for appeals and/or coding guidance for potential re-bills. Maintains a… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …in managing appeals related to payer contract variances and fatal denials . This role is responsible for assisting with appeal documentation, tracking, and ... seeking a *PFS Contract Variance Analyst** *to join our Denials Analysis team. This full-time role will work remotely...process by assisting with intake, documentation, and tracking of appeals submitted to third-party payers * Prepares and submits… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …the end-to-end appeals process related to contract variances and fatal denials . This role serves as a subject matter expert, managing complex appeal cases, ... We are currently seeking a *PFS Contract Variance Analyst Senior** *to join our Denials Analysis team. This full-time role will work remotly (Days, M- F). *Purpose… more