- SUNY Upstate Medical University (Syracuse, NY)
- …to follow up on claim submissions, investigating patient accounts, resolving denials , and fielding all incoming correspondence. Candidate will answer incoming phone ... calls from patients pertaining to billing, insurance, and payments. Minimum Qualifications: 2-3 years Medical Billing Experience- Radiology preferred Follow -up skills Insurance knowledge Payment Experience EPIC Knowledge is a plus Team player as well as the… more
- Guidehouse (Washington, DC)
- …to potential exception requests, including but not limited to license denials , interpretive guidance, or return without action letters. + Research, analyze, ... and document complex financial, trade, and other business activities from a variety of sources, including commercial and open sources, to support sanctions programs. + Review pre-publication requests for sensitive or classified material. + Prepare weekly… more
- TEKsystems (San Antonio, TX)
- …or alternative resources for non-covered chemotherapy services to prevent payment denials . Provides a contact list for patients community resources including special ... programs, drugs and pharmaceutical supplies and financial resources. * Maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization. Adheres to… more
- Mount Sinai Health System (Elmhurst, NY)
- …electronic billing, and Follow Up work queues are monitored for enrollment denials . Supplies additional information as requested from third party carrier. 9. ... Coordinates epaces enrollment and gives access to the provider listing for billing vendor use. 10. Manages One App folder organization and filing format. 11. Provide excellent customer service, answers calls, and assists patients. 12. Performs other related… more
- Molina Healthcare (Rio Rancho, NM)
- …for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and requests for appeals into information system and prepares documentation for ... further review. * Researches claims issues utilizing systems and other available resources. * Assures timeliness and appropriateness of appeals according to state, federal and Molina guidelines. * Requests and obtains medical records, notes, and/or detailed… more
- Trinity Health (Des Moines, IA)
- …as a resource for difficult coding questions and assists with insurance denials for correction and re-filing. . Makes process improvement recommendations to ... management as identified, specifically related to registration and charge posting. . Performs in compliance with federal, state, insurance industry regulations. . Follows established hospital policies concerning corporate compliance. . Keeps abreast of… more
- Avera (Sioux Falls, SD)
- …unpaid, overpaid/over adjusted and denied claims. + Reviews, analyzes, and appeals denials received relative to claims processing issues with insurance payers. + ... Communicates with internal and external customers involved in the claims resolution process to ensure timely claims processing.) Identifies the need to rebill claims through account review and completes claim refiling as well as submits secondary claims not… more
- Omaha Children's Hospital (Omaha, NE)
- …work that involves charge entry, registration, billing, collection/follow-up, payments, refunds, denials , or handles customer service functions. Works to enhance and ... support departmental goals. **Essential Functions** + Performs audits on CBO staff members for accuracy and compliance to department policies and procedures, and industry practices. Creates and updates Employee Reports on QA activities * Evaluates common… more
- Ochsner Health (Jefferson, LA)
- …goals which may include one or more of the following: DNFB, Pre-AR, Denials , and Claim Edits. + Verifies correct discharge disposition when appropriate based on ... medical documentation. + Other related duties as required. The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this… more
- AnMed Health (Anderson, SC)
- …+ Initiates peer-to-peer ie MD to MD calls with payer physician to avoid denials . Qualifications + Minimum of two years of clinical experience required with current ... SC license as RN. + Bachelor of Science in nursing. + Excellent communication skills, written and verbal. + Excellent communication skills and computer experience + Ability to work independently and meet deadlines and schedules Preferred Qualifications +… more