- Community Health Systems (Franklin, TN)
- …the denial and appeal status. + Consults with Coordinator and/or Director, Coding Denials and Appeals during any audit discrepancies. + Attends coding education ... and evaluation of work products by the Coordinator and/or Director, Coding Denials and Appeals . + Partners with peers and Director to develop coder education… more
- Mount Sinai Health System (New York, NY)
- …terms. + Ensure timely and appropriate communication with payers for authorization, denials , and appeals . + Collaborate with physicians and clinical teams ... **Job Description** **Director Pre Appeals Management-HSO Appeals Management -Corporate 42nd Street-Full-Time-Days -Remote** The Director, Pre Appeals … more
- Molina Healthcare (Tampa, FL)
- …subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances, and/or complaints from Molina members, providers,... appeals and denials . * Customer service experience. * Strong organizational and… more
- Omaha Children's Hospital (Omaha, NE)
- …management for insurance and government collections to include claims, A/R follow-up, denials and appeals . This includes supervising, monitoring, and analyzing ... **Schedule: FT, Days, denials exp required (flexible hours)** At Children's Nebraska, our mission is to improve the life of every child through exceptional care,… more
- HCA Healthcare (Brentwood, TN)
- …technical denial arguments for reconsideration. + Identify contract protection to leveraged overturn denials . + Argue appeals that prevent claim payment and gain ... We care like family! Jump-start your career as an Appeals Specialist today with Parallon. **Benefits** Parallon offers a...vary by location._** Come join our team as an Appeals Specialist. We care for our community! Just last… more
- Beth Israel Lahey Health (Plymouth, MA)
- …status of completion. + Reviews and determines appropriate strategy in response to reimbursement denials . + Responsible for appeals and follow up on clinical ... a difference in people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth Israel… more
- University of Washington (Seattle, WA)
- … denials to determine next steps. Additionally, they conduct appeals as appropriate by reviewing medical necessity, and/or reconciling coverage-related issues. ... communicated payer decisions in a timely manner + Review clinical denials and initiate appeals process + Conduct medical necessity reviews, based on denial root… more
- CommonSpirit Health (Englewood, CO)
- …denied claims to determine validity and identify opportunities for overturning inappropriate denials . Leads the appeals process by providing clinical expertise, ... needs of patients and alternative levels of care. **The PA performs denials management and prevention in accordance with the organization's goals and expectations.… more
- Guidehouse (Birmingham, AL)
- …Medical Record + Making outbound calls to Insurance Companies to resolve claim denials and account balances. + Performing Non-Clinical Appeals . + Assisting ... or equivalent. + 0-2 years medical provider experience working with UB04, appeals & denials . **What Would Be Nice to Have** **:** + Basic computer skills.… more
- Houston Methodist (Sugar Land, TX)
- …processes, managed care contracts and coordination of benefits related to coverage, clinical appeals , and denials to include knowledge of CPT and ICD codes ... At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing...review activities, and monitoring the clinical denial management and appeals process, as applicable, in collaboration with clinical team… more