- 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
- BrightSpring Health Services (Englewood, CO)
- …towards individual and company goals for cash collections, credit balances, medical records, correspondence, appeals /disputes, accounts receivable over 90 days, ... state/federal regulations, company policies, insurance contracts in terms of medical policies, payments, patient financial responsibility, credit balances, and… more
- Centene Corporation (Jefferson City, MO)
- …leading clinical coding compliance nurses and non-clinical team members through medical claim review. Ensure compliance with coding practices through a comprehensive ... review and analysis of medical claims, medical records, claims history, state...and resolves escalated health plan, Claims department, and provider inquires/ appeals or issues + Cross communication with IT, health… more
- Rochester Regional Health (Rochester, NY)
- …DEPARTMENT: Patient Financial Services Hours: 37.5 SCHEDULE: Monday-Friday 8AM-4PM SUMMARY: A Medical Billing and Denials Specialist is responsible for managing ... by identifying trends in denials and taking corrective actions. RESPONSIBILITIES: + Medical Billing & Claims Management: Submit and track insurance claims, resolve… more
- CalSTRS (Sacramento, CA)
- …to evaluate, prepare for, and provide expert testimony in the administrative appeals process using details related to applicable laws, regulation, and/or business ... focus on the level of independence reflected in the specialist duty statement (Attached). **Exam** This position requires a...+ Flexible work hours + Remote work options + Medical benefits, including health, dental and vision insurance +… more
- Huron Consulting Group (Chicago, IL)
- …internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and ... internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and… more
- CVS Health (Madison, WI)
- …responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent ... focused medical care, with a focus on clinical and payment...of Aetna clinical and coding policy and experience with appeals , claim review, reimbursement issues, and coding is preferable,… more
- Whidbey General Hospital (Coupeville, WA)
- …governmental guidelines. + Scans all documentation into the patient's electronic medical record. + Maintains a comprehensive filing system that clearly identifies ... and audits. + Inputs statistically numbers in online reports. + Prepares insurance appeals and follows up as required. + Processes technical denials. + Maintains the… more
- State of Colorado (Denver, CO)
- …or the PERA Defined Contribution Plan, plus optional 401K and 457 plans + Medical and dental health plans + Paid life insurance + Automatic short-term (and optional ... Completing the Application Applications will be reviewed by a Human Resources Specialist to determine if you meet the minimum qualifications for the position.… more
- State of Colorado (Colorado Springs, CO)
- …and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov/board-rules . Supplemental Information Please ... and will be reviewed by a qualified Human Resources Specialist to determine if applicants meet the minimum qualifications...addition to offering rewarding, meaningful work, we offer: + Medical and Dental plans + Strong, flexible retirement plans… more