- Rady Children's Hospital San Diego (San Diego, CA)
- …Degree 2 years of experience - hospital billing, processing claim edits, denials , appeals and managing accounts receivable. Experience with Epic Resolute ... Hospital Billing or similar hospital billing systems. In lieu of Bachelor's: 5 years of experience in a lead/supervisory role OR 7+ years of progressive experience in revenue cycle accounts receivable for a large hospital or health system PREFERRED… more
- Sanford Health (Rapid City, SD)
- …improvement, and interaction with payers. Additional duties include management of medical denials , appeals , and grievances. Understand and provide insight into ... evaluating current process improvement strategies including quality, methods, and ability to maintain focus on the continuous improvement of processes, products and services. Manage processes to support attainment of goals within department and organization.… more
- Children's Mercy Kansas City (Kansas City, MO)
- …review functions utilizing InterQual and/or MCG screening guidelines, and clinical denials / appeals oversight. Participates in department and hospital performance ... improvement activities; Responsible for outcomes reporting, quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based and outcome focused family centered care management and services.… more
- Corewell Health (Ludington, MI)
- …verifies that prior authorization has been obtained; assists with retroactive insurance denials / appeals . + Responsible for complex EMR/EHR scanning and Right Fax ... faxing and uploading to EPIC. + Assists with training new team members utilizing standard work. + Ability to perform the role of Patient Services Representative, Associate when necessary. + Actively participates in safety initiatives and risk mitigating… more
- Baylor Scott & White Health (Dallas, TX)
- …file handling Responsibility for the preparation of summaries and files for denials , appeals , medical opinions, subrogation and litigation.1. Collection of ... documents and summarizing information.2. Providing presentations for committee meetings and any required correspondence.3. Applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss… more
- Hackensack Meridian Health (Neptune City, NJ)
- …necessity criteria (eg, MCG, InterQual). + Conduct utilization reviews and manage denials / appeals . + Collaborate with physicians and staff to promote appropriate ... utilization of hospital services. + Participate in interdisciplinary rounds and utilization committees. + Educate medical staff on utilization guidelines and documentation best practices. **Qualifications:** + Unrestricted medical license in the State of New… more
- Robert Half Accountemps (Los Angeles, CA)
- …in medical collections and billing processes. * Strong knowledge of handling medical denials and appeals . * Expertise in working with medical insurance claims ... reversing balances when necessary. * Resubmit corrected claims and prepare appeals in compliance with payer guidelines, ensuring supporting documentation is… more
- Guidehouse (San Marcos, CA)
- …from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up + Customer Service ... Nice To Have** **:** + 1+ year's medical provider experience working with UB04, appeals & denials . + Hospital or EOB claims emphasis + PC skills in a Windows… more
- UNC Health Care (Goldsboro, NC)
- …legal, and compliance guidelines Processes all assigned government and nongovernment accounts and denials for complex financial appeals , with a goal of bringing ... with regulatory, legal, and compliance guidelines. Follows rules for overturning appeals and rejections for these accounts. Completes additional research and… more
- Catholic Health Initiatives (Bismarck, ND)
- …Development & Support:** Actively contribute to innovative programming opportunities, assist with denials and appeals , and participate in community education and ... marketing for the PHP. + **Interdisciplinary Collaboration:** Work effectively within a team environment, participating in staff meetings and professional development opportunities. **Job Requirements** **Qualifications:** + **Education:** Bachelor of Science… more