- CenterWell (Tallahassee, FL)
- …via fax or telephone + Responsible for researching and updating clarifications and denials on patient profiles + Responsible for making or taking phones calls to ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- BayCare Health System (Tampa, FL)
- …assigned by the supervisor including but not limited to processing concurrent denials . + Preferred experience includes Critical Care or Emergency Nursing RN. ... RN (Registered Nurse) + Preferred ACM (Case Management) + Preferred CCM (Case Manager ) **Education:** + Required Associates in Nursing or + Required Bachelors in… more
- Sharp HealthCare (San Diego, CA)
- …MDAudit risk analyzer software, OIG Work plan, CMS, PEPPER Reports, RAC Denials , industry experts, etc. + Policy and Procedure maintenanceWorks in collaboration with ... the Director and Manager of Compliance and System Management (HIM, CDI, Case Management, Quality, etc.) in developing SHC's standardized documentation, medical… more
- SERV Behavioral Health System (Hamilton, NJ)
- …through a wide range of services. JOB SUMMARY: Reporting to the Billing Manager , the Senior Accounts Receivable Specialist will be responsible for billing and ... rates and improve reimbursement processes. + Proactively identifies issues that prevent denials for timely filing. + Follows up and escalates claims as outlined… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …and communities. Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or part of the essential support staff who keep ... work queues, including but not limited to: Insurance verification (Epic RTE), Denials (research root cause, identify trends, correct, appeal), Claim Edits (ensure… more
- Waystar (Atlanta, GA)
- …Enterprise Rule & Edits position reports to our Enterprise Rules & Edits Manager and has the responsibility for establishing new client payer edit configurations. ... onboarding clients on optimizing claim rules and edits to prevent rejections and denials while reducing pended claim volume + Participate in project scoping and… more