- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-driven **UM RN Appeals Coordinator .** This role collaborates with clinical review staff, medical ... to ensure consistent clinical evaluation and processing of medical necessity appeals . Accurate documentation and detailed recordkeeping of notifications to members… more
- Jobleads-US (Chicago, IL)
- …contractual or administrative write-off and provide appropriate justification and documentation. Denials and appeals follow-up including root cause analysis to ... and reviews common errors or misses with physicians and leadership. The Billing Coordinator reflects the mission, vision, and values of NM, adheres to the… more
- Jobleads-US (Miami, FL)
- …knowledge of CPT, ICD-10, charge entry, and claims management processes. Knowledge of appeals process and researching denials as applicable to business needs. ... Possesses effective verbal and written communication skills. Knowledge of Microsoft Systems Word, Excel, Power Point and Access is a must. Must be detail-oriented team player with excellent written and communication skills. Background in coding experience in… more
- Nuvance Health (Danbury, CT)
- …Business Office related to appeals , denial and clinical reviews 9. Reviews new denials and appeal upheld cases in work queue and incoming fax queue. 10. Reviews ... Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician Advisors (PAs) and other stakeholders in ensuring… more
- Crossroads Hospice & Palliative Care (Green, OH)
- …ages and backgrounds + Problem-solving skills to research and resolve discrepancies, denials , appeals , collections Billing Coordinator Schedule & Benefits: ... we can create lasting impacts that transcend medical treatment. Billing Coordinator Responsibilities: + Obtain referrals and pre-authorizations as required for… more
- Catholic Health Services (Melville, NY)
- …Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization ... management and appeals functions to include coordination of specific process and...accurate utilization data in a timely fashion. + Monitors denials as well as all financial metrics associated with… more
- Community Health Systems (Franklin, TN)
- …denial and appeal status. + Consults with Coordinator and/or Director, Coding Denials and Appeals during any audit discrepancies. + Attends coding education ... of work products by the Coordinator and/or Director, Coding Denials and Appeals . + Partners with peers and Director to develop coder education based… more
- Community Health Systems (Franklin, TN)
- …to facilities regarding denials that are resulting in retractions. As an Appeals Specialist II at Community Health Systems (CHS) - SSC Nashville, you'll play a ... **Job Summary** The Appeals Specialist II, under the direction of the...Responsible for review and resolution of pre pay insurance denials , correlating with the follow-up teams. + Works closely… more
- CommonSpirit Health (Englewood, CO)
- …are seeking a highly skilled individual to develop and submit clinical appeals , expertly crafting physician-aligned letters based on federal and state regulations, ... audit-ready case files with denial rationales and P2P documentation, ensuring successful appeals across all levels (1-5), including IRO and ALJ reviews, utilizing… more
- Community Health Systems (Franklin, TN)
- …in Artiva, HMS, Hyland, BARRT, and other host systems, ensuring timely follow-up on denials and appeals . + Conducts follow-up calls and payer portal research to ... **Job Summary** The Denial Coordinator is responsible for reviewing, tracking, and resolving...reviewing, tracking, and resolving denied claims, ensuring that appropriate appeals are submitted, and working closely with payers, internal… more
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