- Texas Health Resources (Arlington, TX)
- …additional reviews to assist departments handling Medicare, OIG, or non-Medicare denials . Provide expert analysis on coding, documentation, and applicable regulatory ... Health Information Administrator Upon Hire Required Or CCS - Certified Coding Specialist Upon Hire Required Or CPC - Certified Professional Coder Upon Hire… more
- BayCare Health System (Tampa, FL)
- …dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions as the primary ... assigned by the supervisor including but not limited to processing concurrent denials . + Preferred experience includes Critical Care or Emergency Nursing RN.… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …than the sum of its parts. Join our dynamic team as a Benefits Investigation Specialist and be a crucial part of ensuring access to essential medications! We seek a ... regional level and alternative resources. + Assists in obtaining insurance approvals/ denials and/or appeals for therapy. Assists patients and HCP with processing… more
- Veterans Affairs, Veterans Health Administration (Fort Meade, SD)
- …services, rejects, or uncoded episodes of care for inpatients Ensures claim denials related to coding errors are resolved, and/or daily coding rejects are ... above the journey level; however, for clinical documentation improvement specialist assignments, a clinical documentation improvement certification may be… more
- University of Rochester (Rochester, NY)
- …Responsible for system edit reviews and follows up on insurance coding denials for resolution. **ESSENTIAL FUNCTIONS** + Uses knowledge of coding systems and ... (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred + Certified Professional Coder (CPC) from American Academy… more
- AdventHealth (Shawnee, KS)
- …patients who no longer meet medical necessity and escalates potential denials , documents avoidable days, and facilitates progression of care. + Collaborates ... Ensures primary care physician identification and scheduling of follow-up PCP and specialist appointments for post hospital follow up care. + Ensures discharge… 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 ... testimonies. Act as a liaison with payers to facilitate approvals and prevent denials or carved out days when appropriate. Provide telephonic and written appeals as… more
- Rochester Regional Health (Rochester, NY)
- …in various system committees and work groups, including billing, revenue cycle, denials , and others as assigned. + Ensure effective staffing levels by evaluating ... duties as assigned. REQUIRED QUALIFICATIONS + Must obtain Certified Clinical Documentation Specialist (CCDS) within two years of hire. + Minimum five years acute… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …when appropriate * Collaborates with department director and professional development specialist to develop standard work and expectations for the utilization review ... manage and respond to all concurrent and post-discharge third party payer denials of outpatient and inpatient cases alleged to be medically inappropriate. Including,… more
- Hartford HealthCare (Farmington, CT)
- …*_Position Summary:_* The Quality Revenue Cycle Billing and Auditor Specialist is responsible for ensuring accuracy, compliance, compliance and efficiency ... trains staff and vendors to prepare and improve colleague's skills for working denials and navigating the billing system (Epic) while assessing training needs and… more