- Avera (Sioux Falls, SD)
- …up of unpaid, overpaid/over adjusted and denied claims. + Reviews, analyzes, and appeals denials received relative to claims processing issues with insurance ... having a high level of knowledge of the Avera Medical Group patient accounts responsibilities for the Avera ...Medical Group patient accounts responsibilities for the Avera Medical Group Clinics. They are responsible for complete follow-up… more
- Covenant Health Inc. (Knoxville, TN)
- …Business Office personnel to resolve issues related to claims, coding, pre-cert, and denials appeals , and verifies that appropriate chargemaster rates are used. ... Overview Coding Specialist , Centralized Coding, Outpatient Coder Full Time, 80...personnel to ensure qualifying diagnosis covers tests/procedures. + Analyzes denials and coordinates appeals . + Ensures corrective… more
- Community Health Systems (Franklin, TN)
- …ensures efficient and effective management of utilization review processes, including denials and appeals activities. This role collaborates with payers, ... potential denials , utilizing input from the Utilization Review Clinical Specialist . + Monitors and updates case management software with documentation of… more
- Sharp HealthCare (San Diego, CA)
- …Collaborate with clinical team to communicate changes in pre-authorization, denial, medical review, appeals , managed care contracts, and referrals to ... of financial planning for their transplant surgery, VAD implant, and future medical needs as well as assuring transplant department billing compliance. The primary… more
- HCA Healthcare (Manchester, NH)
- …purpose and integrity. We care like family! Jump-start your career as a Medical Staff Services Coordinator today with Catholic Medical Center. **Benefits** ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- HCA Healthcare (Aventura, FL)
- …and action taken on the account in accordance with policies and procedures. The Specialist will escalate medical review request and/or denial activities to the ... that invests in you as an Inpatient Authorization Review Specialist ? At Parallon you come first. HCA Healthcare has...the facilities, physicians' offices and/or insurance companies to resolve denials / appeals + Adhere to time and attendance… more
- 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, ... CLinical Documnetaion Specialist on our CDI team at/in Garnet Health Medical Center. Responsibilities Under the direction of The Administrator, Coding & Clinical… 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 ... planning, patient status changes, length of stay, patient monitoring practices, medical necessity concepts and associated regulations in case management decisions.… more
- WMCHealth (Valhalla, NY)
- …addressing appeals to insurance companies and coding highly complex medical records using the current International Classification of Diseases (ICD10 CM/PCS ... role is expected. Does related work as required. Responsibilities: + Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement.… 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