- Hackensack Meridian Health (Hackensack, NJ)
- …ortho calls, payer communications and support of the Care Coordinators. Prepares required Appeals and Denial information for processing and follows up on receipt of ... hour discharge report and providing patients with the IM Letter from Medicare prior to discharge. **Education, Knowledge, Skills and Abilities Required:** + High… more
- Queen's Health System (Honolulu, HI)
- …meetings with payors to resolve payment and denial issues. * Writes and submits appeals to payors on denied accounts. * Audits payments to ensure QMC has received ... in an acute care facility, demonstrating good working knowledge of Medicare , Medicaid, Third Party payor requirements. SNF/ICF, ICD-9/ICD-10 and DRG. *… more
- Huron Consulting Group (Chicago, IL)
- …Tracking and Improvement: Provides analysis and reports of utilization, denials, and appeals KPIs, trends, patterns, and impacts to resources. Tracks, analyzes, and ... and accreditation requirements, ensuring compliance with Maryland state law, Medicare , Medicaid, and third-party payer standards. Oversees completion of utilization… more
- Executive Office for US Attorneys and the Office of the US… (Fresno, CA)
- …the National Environmental Policy Act and other environmental statutes; Social Security, Medicare , and other federal programs; and "Bivens" civil rights actions. The ... cases with substantial responsibility for all aspects of discovery, trial, and appeals . Applicants must demonstrate a quick analytical ability and the facility to… more
- Cognizant (Topeka, KS)
- …billing, with strong knowledge of RARC and CARC codes. . Expertise in Medicare , Medicaid, Managed Care, and Commercial payer processes. . Deep understanding of ... reporting. . Excellent verbal and written communication skills for documentation and appeals . . Ability to meet productivity and quality standards in a fast-paced… more
- HCA Healthcare (Plano, TX)
- …is met in compliance with departmental policies and procedures + Review Medicare Recovery Audit Contractor (RAC) recoupment requests and process or appeal as ... preferred, such as accounts receivable follow-up, insurance follow-up and appeals , insurance posting, professional medical/billing, medical payment posting, and/or… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …and coding guidelines. + Reviewing medical coding claim denials for correction and appeals within the AthenaIDX and Enterprise Task Manager (ETM) systems as assigned ... Location:** El Paso **Preferred Qualifications:** + Extensive knowledge of HIPAA, Medicare and Medicaid guidelines and regulations evaluation and management coding… more
- Sanford Health (MN)
- …Insurance Representative processes and monitors unpaid third party insurance, Medicare , Medicaid or government-assisted program accounts for proper reimbursement. ... advanced knowledge and understanding to process payer rejections. Conducts trend analyses, appeals and resolves low payment or underpaid accounts. Provides input for… more
- Elevance Health (Atlanta, GA)
- …offices and ensures compliance with all Medicaid, Commercial, and Medicare requirements; informs relevant parties of all prior authorization determinations. ... support other lower level pharm techs. + Provides resolution to grievances and appeals issues. Responds to inquiries from physicians, sales team, and members related… more
- HCA Healthcare (Nashville, TN)
- …procedures in place comply with all regulations (Summary of Material Modification, Medicare Part D notices, privacy notices, etc.) + Manage all administrative ... deadlines + Assist the compliance coordinator and ERISA counsel in researching 401k appeals + Monitor and manage Provider Care Group appeal inquiries and escalations… more