- University of Michigan (Ann Arbor, MI)
- Denials Prevention/ Appeals Specialist Apply Now **Job Summary** The Denials Prevention and Appeals Specialist is responsible for ensuring the accuracy ... opportunity employer. **Job Detail** **Job Opening ID** 266022 **Working Title** Denials Prevention/ Appeals Specialist **Job Title** Medical Coder Compliance… more
- St. Mary's Healthcare (Amsterdam, NY)
- …government claim denials and audit requests and coordinates attempts to overturn denials by drafting appeals , negotiating with payers, or following up with ... payer utilization review departments in attempts of obtaining authorizations and claim payment. * Establishes and maintains positive and cooperative relationships with medical staff and care coordination leaders to ensure ongoing compliance with utilization… more
- Guidehouse (Huntsville, AL)
- **Job Family** **:** Clinical Appeals Nurse **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The **R** **emote** ... **Clinical Denials RN** is responsible for review, analysis and appeal...Necessity Reviews + Ensure documentation integrity + Construct warranted appeals + Coordinate pre-service authorization approvals **Duties and Responsibilities:**… more
- R1 RCM (Boise, ID)
- …Assist in establishing and implementing departmental initiatives. Develop and coach team members in skills and process to promote quality. Measure and monitor ... The Billing Team Lead will be responsible for supervising the workflow and day-to-day activities of the team. The Team Lead plays an intricate part in providing analytical expertise for the revenue cycle management process while identifying work flow issues… more
- TEKsystems (Tampa, FL)
- …will be on the bill review team specifically working in the backlog of appeals . The Bill Review Analyst position holds accountability for accurate and timely review, ... and payment of bills to include pre-coding accuracy and adjudication of appeals /provider reconsideration requests. * Examines and adjudicates requests for appeals… more
- Hartford HealthCare (Farmington, CT)
- …review of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials , ... multiple denials , prioritize tasks, and ensure timely submission of appeals . . Experience with electronic health record (EHR) systems, coding software, and… more
- Houston Methodist (Houston, TX)
- …coding 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 and monitoring the coding-specific clinical charges and denial… more
- BronxCare Health System (Bronx, NY)
- …for the staff on identified deficiencies to best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely ... tracking and trending of all denials and appeals , prepare weekly status reports, attend necessary meetings to assist the department attain its objective of… more
- Molina Healthcare (Omaha, NE)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** **Job Summary** Responsible for reviewing... appeals and denials . + Strong verbal and written communication skills +… more
- Beth Israel Lahey Health (Plymouth, MA)
- …status of completion. + Reviews and determines appropriate strategy in response to reimbursement denials . + Responsible for appeals and follow up on clinical ... a difference in people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth Israel… more
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