- Robert Half Accountemps (Los Angeles, CA)
- …within organizational systems. * Analyze and address issues related to medical billing, appeals , and denials . * Provide expertise in managing hospital billing ... standards. * Conduct follow-ups with insurance providers to address unpaid claims, denials , or payment discrepancies. * Collaborate with internal teams and external… more
- Mount Sinai Health System (New York, NY)
- …providers/practices to ensure timely charge entry. 6. May run and work missing charges, edits, denials list and process appeals . Posts denials in EPIC/IDX on ... a timely basis. 7. Posts all payments in IDX using approved methodologies. 8. May perform specialty coding for services and medical office visits and review physician coding and provide updated to physicians and staff. 9. Works TES, BAR and eCommerce edits for… more
- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials ... + Experience in healthcare or revenue cycle - specifically insurance claim denials . + Strong analytical and organizational skills. + Excellent communication and… more
- Dignity Health (Rancho Cordova, CA)
- **Job Summary and Responsibilities** The Appeals and Grievances LVN is a critical role responsible for managing and resolving all medical necessity appeal requests ... entities. This individual acts as a primary liaison for clinical denials , navigating appeal processes through all delegated levels. Key responsibilities include… more
- Highmark Health (Harrisburg, PA)
- …to support services performed. Addresses and resolves potential and actual denials for assigned accounts as well as collaborates with AHN departments/Teams ... in denial prevention activities. **ESSENTIAL RESPONSIBILITIES** + Reviews clinical denials , audits and accounts as assigned.Composes and submits a comprehensive… more
- Guthrie (Binghamton, NY)
- …for review and determination of coverage of ordered medications. + Coordinate and complete appeals for denials as needed + Monitor and Review REMS clearance for ... monthly refills of high-risk medications ordered for patients Monitor and Manage Department in Basket + E-Guthrie Medical Advice Requests + Medication Cancellation notifications + Electronic Refill Requests + System generated Medication Authorization Request +… more
- AbbVie (North Chicago, IL)
- …materials with insurance benefit information such as, but not limited to: appeals and denials processes, payor summary plan descriptions, medical policies, ... formulary listings, fee schedules, etc. + Initiates and manages patient access contracts which includes but is not limited to letters of agreement and contracts with skilled nursing facilities/hospitals. + Assists the pharmacist with practice of pharmacy in… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …coding staff on documentation and coding guidelines. + Reviewing medical coding claim denials for correction and appeals within the AthenaIDX and Enterprise Task ... Manager (ETM) systems as assigned by the business office MPIP personnel, ensuring deadlines are met. + Managing non-coding-related issues within the AthenaIDX and ETM systems and adhering to all timely deadlines. + Performing charge data entry for billing in… more
- NHS Management, LLC (Tuscaloosa, AL)
- …Director of Medicare and Rehabilitation in gathering information for Medicare and Medicaid appeals and denials as requested. + During facility visits, conducts ... an exit interview with the facility Administrator, Director of Nursing, and MDS Coordinator presenting findings from the visit and any recommendations for systems changes. + Formulates a visit report for each facility that summarizes issues that were… more
- Ochsner Health (New Orleans, LA)
- …staff in relation to patient's benefits, pricing structure, authorizations, denial review, appeals on denials , and submission of physician adjustment requests. + ... Assists supervisors with escalated patient inquiries and daily operations of the department. + Provides routine support with new hire and on-going staff training/coaching. + Completes more complex research of a patient's account before submitting/processing… more