- Sun Pharmaceuticals, Inc (Washington, DC)
- …expertise in access and reimbursement issues encompassing coverage, prior authorizations, appeals , exceptions, denials , coding and payer payment guidelines, ... Field Reimbursement Manager Overview: The Field Reimbursement Manager ...and quality programs related to value based care and clinical care pathways. Responsibilities include: + Incorporate knowledge of… more
- Rush University Medical Center (Chicago, IL)
- …position. Offers may vary depending on the circumstances of each case. **Summary:** The system manager of denials prevention and appeals , working in a remote ... of Epic automation and ancillary coding software solutions. The manager will exemplify the Rush mission, vision and values...**Responsibilities:** 1. Oversee the Middle Revenue Cycle Audit and denials team members and appeals process, ensuring… more
- Hartford HealthCare (Farmington, CT)
- …of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials , ... validation denials . This role involves validating the coding and clinical accuracy, ensuring proper documentation, and collaborating with other departments to… more
- Beth Israel Lahey Health (Plymouth, MA)
- … denials . + Responsible for appeals and follow up on clinical denials escalated through a work queue, providing appropriate response supported by ... people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who...UR and the analysis, resolution, monitoring & reporting of clinical denials . + Maintains current knowledge of… more
- University of Southern California (Alhambra, CA)
- …for coding-related denials , triage denied claims to distinguish coding-related denials versus clinical -related denials , evaluating claims deemed ... & state coding compliance regulations and guidelines, the HIM Coding Denials Management Specialist" analyze, investigate, mitigate, and resolve all coding-related… more
- BronxCare Health System (Bronx, NY)
- …best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials ... and Appeals Coordinators, Physician Advisors, and the clinical staff, the Appeal Manager is responsible...to assist the department attain its objective of managing denials and appeals . Responsibilities -Types, utilizing a… more
- Penn Medicine (East Petersburg, PA)
- …Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn ... each day. Are you living your life's work? Job: Denials Management Specialist Hours: Day shift hours, start time...the resolution of the denied claim. + Performs all appeals and denial recovery procedures needed to appropriately and… more
- Guthrie (Sayre, PA)
- …and root causes; develop strategies to reduce preventable denials + Ensure appeals are written and submitted timely, with clinical accuracy and regulatory ... Summary The Denial, Appeal, and Audit Manager is responsible for the oversight and management...responsible for the oversight and management of all payer denials , appeals , and audit processes within the… more
- Garnet Health (Middletown, NY)
- …is responsible for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate ... The Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials … more
- NTT America, Inc. (Plano, TX)
- … to join our team. NTT DATA is seeking to hire a **Medicare Appeals Clinical Leader** to lead service delivery engagements and improve end-to-end delivery ... of Medicare Appeals . Desire experience specifically for processes for clinical appeals coordinators but this role will be a leader in the end-to-end delivery… more
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