- Ascension Health (Jacksonville, FL)
- …improvement, coding, quality and/or compliance processes. + Develop strategy and processes to reduce denials and audits. + Assist with appeals and length of stay ... market initiatives. + Utilize hospital data sources to identify & analyze patterns of over or under-utilization of services, quality metrics and collaborate with appropriate stakeholders to help achieve those goals. **About Ascension St. Vincent's Hospitals… more
- Alabama Oncology (Birmingham, AL)
- …claims and take the appropriate action, including completion of submissions, reconsiderations, appeals , or re-working denials , to ensure payment is received ... timely. Essential Duties and Responsibilities: + Performs audits of patient accounts to ensure accuracy and timely payment. + Reviews account aging monthly and reports inconsistencies and correct errors as appropriate. + Follows up on insurance billing to… more
- UCLA Health (Inglewood, CA)
- …guidelines. + Provides quality control checks on paper claims; processes tracers, denials , and related correspondence; + Initiates appeals ; drafts, composes, and ... submits appeal letters specific to coding issues consistent with the most updated American Medical Association Current Procedural Terminology. + Identifies and reports any potential compliance risks and reimbursement opportunities to the Revenue Cycle… more
- Robert Half Finance & Accounting (Roslyn Heights, NY)
- …underpaid claims from insurance carriers based on contracted fee schedules. * Submit appeals for inappropriate insurance denials in a timely manner. * ... Communicate with patients to resolve questions about their claims, coverage, and billing concerns. * Validate overpayment refund requests from insurance carriers to ensure accuracy. * Monitor and identify trends among payors that impact revenue. * Participate… more
- Tufts Medicine (Melrose, MA)
- …health insurers, follows up with health insurers about submitted claims, and performs appeals for non-clinical denials , etc. An organizational related support or ... service (administrative or clerical) role or a role that focuses on support of daily business activities (eg, technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or… more
- Tufts Medicine (Tyngsboro, MA)
- …health insurers, follows up with health insurers about submitted claims, and performs appeals for non-clinical denials , etc. An organizational related support or ... service (administrative or clerical) role or a role that focuses on support of daily business activities (eg, technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or… more
- Robert Half Finance & Accounting (Colorado Springs, CO)
- …through third-party clearinghouses, ensuring timely processing. * Post and process verified denials during accounts receivable activities. * Submit appeals for ... denied claims and handle overpayments from third-party payers. * Collaborate with government and third-party insurers to follow up on missing or improperly denied claims. * Support the team by verifying eligibility and benefits for in-office surgeries,… more
- WMCHealth (Valhalla, NY)
- …+ Keeps abreast of regulatory changes affecting coding. + Reviews denials from insurance companies and drafts appeals . Qualifications/Requirements: Experience: ... Minimum of 2-3 years related experience in acute car environment; must be proficient with multiple EMR systems, 3M Encoder and have a minimum of 5 years' experience specializing in inpatient. Education: Bachelor's degree in a health related field, required. Or… more
- Bear Mountain Health Care (MA)
- …resident responsibility, discuss Patient Liability payments, per policy . Respond to denials , which may include attendance of appeals or submission of ... reapplication . Work in collaboration with the facility Business Office staff to coordinate efforts to approval . Prepare reports and attend Medicaid Pending meetings with Regional team Requirements include: . Strong knowledge of the Medicaid application… more
- Fallon Health (Worcester, MA)
- …regarding the grievance/appeal. + Acts as the initial investigator for provider appeals related to filing limit, claim denials , claim payment, retrospective ... on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with… more