• Registered Nurse Clinical Denials

    Catholic Health (Buffalo, NY)
    …liaison between front-end clinical areas and third party payers in scenarios related to denials and appeals . This position educates all members of the patient ... position is accountable for carrying out and documenting the appeals process for denied claims denied due to reasons...on an ongoing basis in relation to trends in denials , and clinical documentation. Responsible for working alongside coding,… more
    Catholic Health (04/23/25)
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  • Manager - Utilization Review…

    Beth Israel Lahey Health (Plymouth, MA)
    …making a difference in people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth ... Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs...Reviews and determines appropriate strategy in response to reimbursement denials . + Responsible for appeals and follow… more
    Beth Israel Lahey Health (04/29/25)
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  • Claims Denials Supervisor- MDLIVE

    The Cigna Group (Houston, TX)
    …HCPCS Guidelines, AMA CPT Guidelines, and CMS directives, as related to claim denials and appeals + Pursues collection activities to obtain reimbursement from ... experience preferred + 5+ years of supervisor or manager experience preferred + 2+ years minimum of front...email, Salesforce + Working Knowledge of Health Insurance EOB's, denials and appeals + Ability to meet… more
    The Cigna Group (05/08/25)
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  • Denials Management RN Specialist Remote

    AdventHealth (Altamonte Springs, FL)
    …contribute:** This position is responsible for investigating and appealing post-remit denials for all Inpatient and Outpatient clinical services across the system, ... will bring to the team:** + Reviewing and appealing denials for all clinical services across the AH system...obtain further patient information to be used in the appeals process if necessary. + Provide reports, education, and… more
    AdventHealth (05/06/25)
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  • Clinical Appeals Coordinator - Pennsylvania…

    Penn Medicine (Philadelphia, PA)
    …shortages.Coordinator is responsible for management of lists and processes related to denials and appeals .Coordinator also prepares quarterly denial reports by ... Experience:** + Bachelors degree in Nursing and 5+ years Working as a RN Case Manager and /or Appeals Coordinator required. We believe that the best care for… more
    Penn Medicine (04/29/25)
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  • Manager Collections

    Methodist Health System (Dallas, TX)
    …Of Week :** Mon-Fri **Work Shift :** **Job Description :** Your Job: The Manager of Collections Physician Billing is responsible for overseeing the AR follow up team ... drive performance improvements and meet departmental and organizational goals. The Manager will work closely with various internal and external departments,… more
    Methodist Health System (05/01/25)
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  • Revenue Cycle Billing Manager

    Ophthalmic Consultants of Boston (Plymouth, MA)
    …operations. This role handles a high volume of claims processing, insurance denials , appeals , contract management, prior authorization submissions, and managing ... with a demonstrated ability to apply this knowledge to claim processing and appeals . + Extensive experience managing insurance denials , appeals , and… more
    Ophthalmic Consultants of Boston (04/11/25)
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  • Delivery Senior Manager

    NTT America, Inc. (Plano, TX)
    …and forward-thinking organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is seeking to hire a **Medicare ... Appeals Clinical Leader** to lead service delivery engagements and...interpret medical records, documenting recommendations to uphold or overturn denials + Excellent analytical and problem-solving skills + Strong… more
    NTT America, Inc. (04/30/25)
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  • Patient Account Representative - Billing & Coding,…

    Surgery Care Affiliates (Boise, ID)
    …Effectively and independently manages second level reimbursement issues, contracted and non-contracted denials and appeals . + This is a demanding environment, ... by working with insurance providers to resolve issues. + Denials and Claims: + Handle denials and...and ensure proper reimbursement. + Notify the Billing Office Manager of any issues or claims that cannot be… more
    Surgery Care Affiliates (03/05/25)
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  • Manager Revenue Cycle - Self-pay…

    Houston Methodist (Katy, TX)
    …to: medical coding, insurance billing, collections, patient account resolution, appeals / denials , customer service, cash applications, revenue integrity, etc. ... At Houston Methodist, the Manager Revenue Cycle position is responsible for the...limited to the following: accounts receivable days, cash collections, denials , avoidable write-offs, staff productivity and work quality and… more
    Houston Methodist (05/01/25)
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