• Clinical Denials & Appeals

    Northwell Health (Melville, NY)
    …needed. Preferred Skills 3-5 years experience in Utilization Review, Case Management, and Clinical Appeals . 3-5 years of acute inpatient clinical experience. ... with current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity… more
    Northwell Health (08/20/25)
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  • Denials Specialist 2 / HIM Coding

    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 , ... **Job:** **Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 2 / HIM Coding* **Location:**… more
    Hartford HealthCare (07/01/25)
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  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    …and billing processes, managed care contracts and coordination of benefits related to coverage, clinical appeals , and denials to include knowledge of CPT and ... and denials for no authorization. The Senior Denials Management Specialist position communicates clinical...cycle clinical role + Experience includes writing clinical appeals for medical necessity compliance or… more
    Houston Methodist (07/31/25)
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  • Coding Charges & Denials Specialist

    Houston Methodist (Houston, TX)
    …staff; and functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS** + Communicates openly in a ... At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating... is responsible for coordinating and monitoring the coding-specific clinical charges and denial management and appeals more
    Houston Methodist (07/18/25)
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  • Denials Management Specialist

    St. Luke's University Health Network (Allentown, PA)
    …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... and rejections. + Assists in preparing reports regarding denials to include volumes, number of appeals ,...preferred. TRAINING AND EXPERIENCE: Minimum of 2-5 years of clinical nursing experience in an acute care hospital setting… more
    St. Luke's University Health Network (08/19/25)
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  • Clinical Denials Coordinator

    UNC Health Care (Goldsboro, NC)
    …Reviews all denial requests and leads the team in the strategy to appeal all clinical denials . Provides the clinical expertise to draft the first and ... for issues related to reimbursement, denials , status, etc. 6. Evaluates clinical denials for validity and probability to overturn, proactively gathers… more
    UNC Health Care (08/14/25)
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  • Inpatient Coding Denials Specialist

    HCA Healthcare (San Antonio, TX)
    …and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts ... you want to join an organization that invests in you as an Inpatient Coding Denials Specialist ? At Parallon, you come first. HCA Healthcare has committed up to… more
    HCA Healthcare (07/26/25)
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  • RN Clinical Review Appeals

    St. Luke's University Health Network (Allentown, PA)
    …serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, ... needed for workflow or identification of trends. Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and… more
    St. Luke's University Health Network (07/08/25)
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  • Clinical Appeals Spec.

    BJC HealthCare (St. Louis, MO)
    …Responsible for resolving clinical denials for BJC hospitals and payors. The Clinical Appeals Specialist must be able to multi-task and maintain a ... Information About the Role** BJC HealthCare is seeking a Clinical Appeals Specialist for infusions!...prevent denials . + Effectively communicates with the Clinical Appeals team and works with contracted… more
    BJC HealthCare (08/08/25)
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  • Prior Authorization and Appeals

    AscellaHealth (Berwyn, PA)
    … process. + Respond to Prior Authorization denials and submit appeals , collecting appropriate clinical support to substantiate the formal response. + ... What we are looking for Optime Care seeks a Prior Authorization and Appeals Specialist for our Berwyn, PA location. We are looking for someone who is passionate… more
    AscellaHealth (08/01/25)
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