- CommonSpirit Health Mountain Region (Centennial, CO)
- …to help you flourish and leaders who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management liaison for all care ... external third-party payers to appeal denied claims and retrospectively identifies appeals determination as indicated through research and coordination of completion… more
- WMCHealth (Valhalla, NY)
- Denials and Appeals Mngmt Cord Company: WMC Advanced Physician Services PC City/State: Valhalla, NY Category: Clerical/Administrative Support Department: ... Details: Job Summary: Decrease the monies lost to insurance companies due to denials . Generate appropriate appeals , both retrospective and concurrent, based on… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The Manager, Denials Prevention & Appeals Operations is responsible for the direct oversight of daily operations of clinical denial ... medical necessity. This position will work closely with the Denials Prevention & Appeals Administration Manager to guide the development and implementation of… more
- Catholic Health (Buffalo, NY)
- …hours based on role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for the people, carrying ... between front-end clinical areas and third-party payers in scenarios related to denials and appeals . This position educates all members of the patient care team… more
- Carle Health (Normal, IL)
- …Responsible for handling escalated account and payer issues. Handles complex edits, appeals and account activities such as advanced level tasks, bankruptcies, Risk ... workers' compensation reimbursement computation forms and attorney requests.Handles escalated appeals .Assists with training and education to staff for accuracy.Identifies… 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
- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ... notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the... and communicating on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care… more
- Cognizant (Washington, DC)
- …advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process includes ... analyzing, reviewing, and processing medical necessity denials for resolution. You will be a valued member of the Cognizant team and work collaboratively with… 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
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