- Stanford Health Care (Palo Alto, CA)
- …excellent analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding ... **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist II plays a critical role in the Revenue...Denials Management Department by managing and resolving clinical appeals related to government audits and denials .… more
- Stony Brook University (East Setauket, NY)
- Revenue Specialist **Position Summary** At Stony Brook Medicine, a **Revenue Specialist ** will provide operational support within the hospital's Patient ... business functions including but not limited to: billing, claims analysis appeals , follow-up, financial assistance and customer service. **Duties of a Revenue… more
- CommonSpirit Health (Centennial, CO)
- …to help you flourish and leaders who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management liaison for all ... external third-party payers to appeal denied claims and retrospectively identifies appeals determination as indicated through research and coordination of completion… more
- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ... notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the... and communicating on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care… more
- Nuvance Health (Danbury, CT)
- …*Summary:* Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician Advisors (PAs) and other stakeholders ... in liaising with all above parties to submit provider appeals to insurance companies including Medicare and Medicaid for...appeals , denial and clinical reviews 9. Reviews new denials and appeal upheld cases in work queue and… more
- Hartford HealthCare (Farmington, CT)
- …**Job:** **Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 2 / HIM Coding* **Location:** ... review of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials ,… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... and denials for no authorization. The Senior Denials Management Specialist position communicates clinical information...contracts and coordination of benefits related to coverage, clinical appeals , and denials to include knowledge of… more
- University of Southern California (Alhambra, CA)
- …federal & state coding compliance regulations and guidelines, the HIM Coding Denials Management Specialist " analyze, investigate, mitigate, and resolve all ... appeal. Performs all 1st and 2nd level coding-related denial appeals . All tasks & duties to be perform in...will provide guidance and training to other HIM Coding Denials Management Specialist , and will assist with… more
- Fairview Health Services (St. Paul, MN)
- **Job Overview** The Inpatient Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by the ... pertaining to billing, coding, and documentation. The Inpatient Coding Denials Specialist will also handle audit-related and...appeals or re-billing of claims to resolve coding denials to ensure collection of expected payment and mitigation… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Medical Billing & Denials Specialist Department: Patient Financial Services Location: SLH - Regional Administrative Campus Hours Per Week: 40 ... Schedule: 8am-4pm SUMMARY: A Medical Billing and Denials Specialist is responsible for managing the...fee schedules, DRGs, and reimbursement procedures. + Claims and Appeals Processing: Submits and follows up on insurance claims;… more
