- 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
- 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 (Burlington, MA)
- …Billing Office. 15. Independently works on the resolution of complex claims issues, denials , and appeals . 16. Completes projects and research as assigned. 17. ... job, you're making a difference in people's lives.** The Denials Specialist 3 role specializes in high-dollar claims, aged...practice, and user trends and makes recommendations to the Manager of Revenue System Operations and partners with the… more
- TEKsystems (Annapolis, MD)
- …prevention of clinical denials . This staff member reviews all initial clinical denials to determine next steps and conducts appeals as appropriate, such as ... clinical denial appeals specialist also works to prevent future clinical denials by communicating with clinical and revenue cycle leadership about denial root… more
- AdventHealth (Altamonte Springs, FL)
- …or manager if necessary. + Processes administrative and medical appeals , refunds, reinstatements, and rejections of insurance claims. + Communicates consistently ... role you will contribute:** Responsible for billing, follow-up, and managing denials to timely collect on assigned accounts receivable. This position communicates… more
- BronxCare Health System (Bronx, NY)
- Overview Assists in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute ... action in order to improve outcomes. - Maintains an excel log related to denials / appeals activities in order to monitor successful appeals . - Assists with… more
- St. Luke's University Health Network (Allentown, PA)
- …to, physicians, hospital employees and vendors. Advises Network CDI & DRG Denials Manager on issues requiring immediate attention. ADDITIONAL REQUIREMENTS: ... regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of… more
- 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
- Houston Methodist (Houston, TX)
- …services. This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in ... Supervisor. + Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further...queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits… more
- Covenant Health Inc. (Knoxville, TN)
- …guidelines. + Provides education to auditors, nurse and coders in department relative to denials and appeals processes based on final review of denial. Escalates ... level professional internal analysis related to root cause and resolution of denials for corrective action. Work involves research and analysis of revenue cycle… more
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