- Covenant Health Inc. (Knoxville, TN)
- …+ Demonstrates problem-solving and critical thinking skills in analyzing rejections and/or denials to determine root-cause and best course of action to resolve ... account issues. Able to identify rejection and denials trends and report to the appropriate contact for tracking and/or further investigation. + Demonstrates… more
- NYU Rory Meyers College of Nursing (New York, NY)
- …and recover outstanding receivables. Identify trends in payments, underpayment/overpayments and denials . Work with respective departments to evaluate trends and be ... the revenue cycle processes. Directly manage and resolve all assigned underpayment appeals , follow-up and payer relationships. Report to management any gross payment… more
- Queen's Health System (Honolulu, HI)
- …audits, creating reports and implementing process changes, to minimize and/or prevent denials . * Follows up on insurance claims with outstanding balances; leads ... resolve payment and denial issues. * Writes and submits appeals to payors on denied accounts. * Audits payments...analysis. Creates, reviews and distributes accounts receivable reports on denials , audits, payment trends, and AR status. * Meets… more
- Mount Sinai Health System (New York, NY)
- …facilitates and tracks concurrent adverse determinations and collaborates with Appeals Management Department in managing retrospective denials . ... MSH, Mount Sinai Hospital **Responsibilities** 1. **Admission: Payer Authorization & Denials Management.** Communicate with payer to obtain request for clinical… more
- Mohawk Valley Health System (Utica, NY)
- …throughout the medical staff. + Assist case managers with Medicare and Medicaid appeals and Administrative Law Judge (ALJ) testimonies. Act as a liaison with payers ... to facilitate approvals and prevent denials or carved out days when appropriate. Provide telephonic...carved out days when appropriate. Provide telephonic and written appeals as requested for commercial payors. + Perform reviews… more
- Trinity Health (Fort Wayne, IN)
- …to benefits investigation, prior authorization request and submission, overturning appeals , and enrolling patient in financial assistance programs. Manages the ... each contact made to the patient, provider, and insurance plan. Facilitates appeals process between the patient, physician, and insurance company by requesting… more
- Stony Brook University (East Setauket, NY)
- …business functions including but not limited to: billing, claims analysis appeals , follow-up, financial assistance and customer service. **Duties of a Revenue ... limited to:** + Prepare and submit hospital claims. Review denials . Investigate coding issue. Audits. + Follow-up on rejected...denied claims, improper payments and coding issues. + Process appeals . + Liaise with third party billing and collection… more
- Guthrie (Sayre, PA)
- …necessary action to complete all types of complex insurance billings and appeals . Reviews and analyzes the insurance processing procedures to identify potential ... and skills for the position. Essential Functions: 1. Identifies and evaluates denials for assigned payers and/or specialties to determine specific issues and… more
- Growth Ortho (Sioux Falls, SD)
- h1 data-start="108" data-end="187">Reimbursement Specialist - Payments, Denials , A/R (ASC Experience Required) Location: Flexible (Sioux Falls, SD preferred, but ... optimal reimbursement outcomes. Key Responsibilities Accurately post payments and denials , reconciling against bank deposits. Review and process patient refunds… more
- Sharp HealthCare (San Diego, CA)
- …benefits and accurately follows Health Plan and/or Medicare Guidelines when issuing denials .Ensures that all denials for medical necessity are issued under ... issued accurately and served timely to members or responsible party.Ensures that all denials for medical necessity are issued under the direction of the appropriate… more