- Robert Half Accountemps (Indianapolis, IN)
- …1+ years of experience in medical collections, healthcare accounts receivable follow-up, denials & appeals , compliance, provider relations, or medical billing. + ... payers to follow up on outstanding claims, submit technical and clinical appeals , resolve payment variances, and secure timely and accurate reimbursement. + Identify… more
- Virtua Health (Moorestown, NJ)
- …open communication with management regarding billing and coding issues including documentation, denials / appeals , etc.* Follows up on assigned insurances on a ... and complete.* Analyzes, identifies and trends billing issues to proactively reduce denials and variances.* Works system generated reports such as residual balance,… more
- Garnet Health (Middletown, NY)
- …responsible for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, ... completeness, and accuracy of medical record documentation. The Manager will evaluate denials and work closely with the outcomes manager and coding denial… more
- BJC HealthCare (St. Louis, MO)
- …for resolving clinical denials for BJC hospitals and payors. The Clinical Appeals Specialist must be able to multi-task and maintain a high level of ... payer denials . Collaborates to develop best practices procedures to prevent denials . + Effectively communicates with the Clinical Appeals team and works… more
- HCA Healthcare (Nashville, TN)
- …requests for intervention from the centralized peer-to-peer team and others regarding denials and appeals processes, observation level of care, decisions about ... + Proactively identify and address payer medical policies that lead to inappropriate denials , advocating for fair and accurate coverage. + Provide crucial support to… more
- University of Utah (Salt Lake City, UT)
- …account resolution of MAC 1 & 2 team members. + Monitor and resolve denials and appeals to ensure timely collection. + Maintain work queue expectations. ... + Identifies, analyzes, and researches frequent root causes of denials and develops corrective action plans for resolution of... and develops corrective action plans for resolution of denials working directly with the payers. + Training &… more
- Texas Health Resources (Arlington, TX)
- …and financial data (eg, LOS data, avoidable days, adverse determinations, and denials / appeals ) and makes recommendations to improve performance. Achieves and ... Code 44 intervention, HINN letters, IMM, Observation letter, etc. Potential denials , avoidable days, alternate level of care days, etc. Medical necessity… more
- Texas Health Resources (Frisco, TX)
- …and financial data (eg, LOS data, avoidable days, adverse determinations, and denials / appeals ) and makes recommendations to improve performance. Achieves and ... Code 44 intervention, HINN letters, Second IMM, Observation letter, etc. Potential denials , avoidable days, alternate level of care days, etc. Medical necessity… more
- Highmark Health (Pittsburgh, PA)
- …and contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials / appeals and retrospective payer audit denials . ... Collaboratively formulates plans of action for denial trends with the care coordination teams, performance improvement teams, physicians/physician advisor and third party payers. + Maintains a working knowledge of care management, care coordination changes,… more
- Robert Half Accountemps (Los Angeles, CA)
- …payer contracts, processing contractual adjustments, knowledge of late charge process. * Appeals and denials management. *Primary, secondary, and tertiary ... operations. * Proficiency in medical billing and collections, including handling denials and appeals . * Strong knowledge of Explanation of Benefits (EOBs) and… more