• 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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  • Clinical Denial Appeals

    TEKsystems (Annapolis, MD)
    Description Position Summary The clinical denial appeals specialist is responsible for the identification, mitigation, and prevention of clinical ... This staff member reviews all initial clinical denials to determine next steps and conducts appeals...responding to authorization concerns, and/or reconciling coverage-related issues. The clinical denial appeals specialist also… more
    TEKsystems (08/26/25)
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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 (El Paso, 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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  • Coding Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... or AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and… more
    St. Luke's University Health Network (08/18/25)
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