- BrightSpring Health Services (Lubbock, TX)
- …to meet the needs of the pharmacy. + Identifies and resolves issues of denials or follow-up of claims. + Maintains current knowledge of Medicaid claim regulations ... and processes. + Produces reports and keeps management informed of unpaid claims and claims pending follow-up. + Understands all dispensing systems used in the pharmacy and their implications for data entry. + Processes prescriptions by triaging and inputting… more
- UCLA Health (Los Angeles, CA)
- …to CLIA Management (operational licensing and compliance) and finance-related issues ( denials , rejects, rebills, and updating the EHR). You will communicate with ... clinic managers, clinic supervisors, CDPH, and CMS to ensure all community clinics have the appropriate licensures and that all CDPH and CMS guidelines are enforced. You will: + Identify, assess, and implement organizational readiness and stakeholder alignment… more
- Baystate Health (Springfield, MA)
- …Surgical Services, Risk Management, Patient Financial Services, Information Technology, Denials , and Capacity Management teams to ensure coordination of services ... for patients, providers, Practice Managers/Supervisors/Nurse Managers Responsibilities include ensuring adequate assignments of physicians in all sites of care including practice locations, operating rooms, procedural suites, and consulting services to ensure… more
- Bear Mountain Health Care (Hanover, NH)
- …all necessary paperwork from Managed Care companies including authorizations and denials for admission - Communicate with facility, hospitals, and liaisons regarding ... patient status, availability, and potential admissions. - Marketing and media campaign efforts. Qualifications + Previous experience in Skilled Nursing facility a plus + Familiarity with medical software and equipment + Calm demeanor + Ability to thrive in a… more
- Cardinal Health (Fresno, CA)
- …identify root causes and improvement opportunities. + Research CPT code denials against LCD/NCD requirements and payer policies. + Collaborate with cross-functional ... teams to implement clean claim strategies and reduce rework. + Serve as a liaison between billing staff, providers, and center leadership to resolve escalated issues. Communicate payer updates and industry changes to staff and leadership. + Participate in… more
- BrightSpring Health Services (Phoenix, AZ)
- …claims are billed in a timely manner + Work with operations to resolve denials + Complete month-end close processes, such as revenue balancing and reporting + Lead ... monthly AR calls with assigned operations to work aging as well as participate in monthly Critical Account calls for the entire region + Follow proper procedures for revenue adjustments + Work unapplied cash and complete cash transfers, including daily cash… more
- Brockton Hospital (Brockton, MA)
- …rounds. Proactively builds post hospital referrals and sends to the Transition Care Coordinator when indicated to facilitate timely discharge. Acts as a change agent ... ensure compliance with Signature Healthcare Hospital standards, prompt notification of denials , questionable cases and cases referred for outside review. Monitors… more
- University of Utah Health (Salt Lake City, UT)
- …EO/AA_ This position is responsible for insurance receivables collections, denials resolution and internal/external customer service. Account portfolio may include ... as assigned by payer/contract/benefit. + Resolves clinical and/or authorization denials through CARC analysis and appeals - including clinical documentation… more
- St. Luke's University Health Network (Allentown, PA)
- …clean claim submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across the network. Utilizes ... coding errors and MUE frequency for clean claim submission + Resolve coding denials through claim correction or appeal. Claim corrections will be made after review… more
- ChenMed (Miami, FL)
- …rehabilitation facility staff. The incumbent is responsible for training new Post Acute Coordinator (PHC) and quality assurance of their work of a defined region. ... processes, contribution to team growth and data quality strategy, Post Acute Coordinator interviewing and function coverage in regions outside of their usual Post… more