- 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
- State of Massachusetts (Boston, MA)
- …to Pharmacy Benefit Managers and the processing of insured health plans' pharmacy benefit denials and appeals as overseen by OPP. * Participate in meetings with ... other state personnel, including parties representing the Governor's Office; Executive Office of Economic Development agencies, Executive Office of Health and Human Service agencies, and Executive Office for Administration and Finance agencies; the Attorney… more
- Huron Consulting Group (Chicago, IL)
- …met. + Performance Tracking and Improvement: Provides analysis and reports of utilization, denials , and appeals KPIs, trends, patterns, and impacts to resources. ... Tracks, analyzes, and implements strategies to improve team performance based on utilization trends and identifies performance indicators, initiates monitoring process improvements. Accountable to PI performance. + Compliance and Regulatory Oversight:… 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 ... all activities to adhere to department standards and maximize operations revenue. Provides day-to-day work direction and guidance, including delegating work, facilitating adherence to department and organization standards and mentoring. Develops, implements… more
- University of Southern California (Arcadia, CA)
- …mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials , and appeals . + Collaborates and communicates with multidisciplinary team ... in all phases of discharge planning process, including initial patient assessment, planning, implementation, interdisciplinary collaboration, teaching, and ongoing evaluation. + Collaborates with medical staff, nursing staff, and ancillary staff to eliminate… more
- Trinity Health (Philadelphia, PA)
- …treatment plan, while observing quality and patient safety parameters, LOS, readmissions, denials and appeals . **Minimum Qualifications:** + Bachelor's degree in ... nursing required. + Active PA RN License required. + Three (3) years of utilization management or case management experience, including emphasis on discharge planning. + Case Management certification from an accredited organization preferred **We offer a… more
- WMCHealth (Suffern, NY)
- …to the hospital to ensure patient has coverage, services provided are covered, denials and appeals minimized and payments are expedited. + Reviews registration ... data for accuracy and satisfying delinquent data for a quality assurance. + Handles the printing and distribution of Admission/Registration forms, face sheets, labels and NY State and Federally mandated forms to patients or nursing unit as appropriate. +… more
- WMCHealth (Port Jervis, NY)
- …to the hospital to ensure patient has coverage, services provided are covered, denials and appeals minimized and payments are expedited. + Reviews registration ... data for accuracy and satisfying delinquent data for a quality assurance. + Handles the printing and distribution of Admission/Registration forms, face sheets, labels and NY State and Federally mandated forms to patients or nursing unit as appropriate. +… more
- BrightSpring Health Services (Nashville, TN)
- …Sr Director's responsibilities include identifying reimbursement issues, ensuring that claims, denials , and appeals are efficiently processed, and resolving ... billing-related issues. This position will work in collaboration with Contracting, Field Branch Operations, Credentialing, and central functions at Support Center including Cash Control and Accounting. They should be able to lead strategic initiatives, utilize… more
- Guthrie (Cortland, NY)
- …other hospital departments as appropriate to track and monitor the status for denials and appeals . + Participates in performance improvement and educational ... activities. + Serves as an educational resource to other members of the healthcare team with regards to changes in reimbursement, payers, and/or utilization requirements. + Participates in departmental long-range planning to meet the needs identified through… more