- 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, ... your career home with us as a CLinical Documnetaion Specialist on our CDI team at/in Garnet Health Medical...accuracy of medical record documentation. The Manager will evaluate denials and work closely with the outcomes manager and… more
- Mohawk Valley Health System (Utica, NY)
- …and advisory services to physicians, case managers and clinical documentation specialist regarding correct level of care and reimbursement. Apply knowledge of ... staff. + Assist case managers with Medicare and Medicaid appeals and Administrative Law Judge (ALJ) testimonies. Act as...a liaison with payers to facilitate approvals and prevent denials or carved out days when appropriate. Provide telephonic… more
- WMCHealth (Valhalla, NY)
- …role is expected. Does related work as required. Responsibilities: + Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement. ... Job Details: Job Summary: The Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using the… more
- AdventHealth (Tampa, FL)
- …claim denials to perform the appropriate resolution, rebilling, and/or appeals steps. Assists with developing and implementing strategies and procedures to ... reduce denials , maximize reimbursements, and promote faster payment. Resolves claim...Certified Pension Consultant (CPC) Required or + CCS-Certified Coding Specialist Required This facility is an equal opportunity employer… more
- Cardinal Health (Sacramento, CA)
- …in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + ... prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and...Processes denials & rejections for re-submission (billing) in accordance with… more
- Ventura County (Ventura, CA)
- …rate, compliance rate with quality standards and HCAI requirements; + Reviews insurance denials and submit appeals as necessary, provide education to coders ... strong Inpatient and Outpatient coding experience and Certified Coding Specialist certification combined with extensive supervisory experience overseeing other...based on denials ; + Assists in organizing, coordinating, and directing of… more
- Avera (Sioux Falls, SD)
- …will do** + Design, maintain, and enhance dashboards and scorecards for denials , write-offs, payer performance, and charge activity. Analyze trends and translate ... Not Billed (DNB) accounts to ensure timely claim submission. + Investigate denials and underpayments, identify root causes, and recommend process improvements. +… more
- HCA Healthcare (Manchester, NH)
- …actions on a practitioner's RFC, R-RFC, including resignations, terminations, LOAs, denials , terminations, or withdrawals in accordance with CPC-28 and MSS013. ... MEDITECH Practitioner Dictionary/Database to reflect all board actions including approvals, denials or terminations in accordance with CPC-28 and MSS-013. Update… more
- BrightSpring Health Services (Valdosta, GA)
- …the month for assigned Operations. + Timely follow up on insurance claim denials , exceptions, or exclusions. + Maintain open communication with Billing Specialist ... patients, and providers. + Works in Waystar to identify denials and timely resolution. + Timely follow up of...Billing Portal sites, preferred. + Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement… more
- University of Southern California (Alhambra, CA)
- The Collector Appeal Specialist is responsible for accurately processing inpatient and out-patient claims to third party payers and private pays, following all ... and electronic claims; process tracers, denial and related correspondence; initiate appeals ; compose and submit appeal letters specific challengeable denial issues… more