- 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 ... issues related to reimbursement, denials , status, etc. 6. Evaluates clinical denials for validity and probability to overturn, proactively gathers required … more
- Novant Health (Bolivia, NC)
- Job Summary The Patient Services Coordinator IV team member's job responsibility is to deliver the most remarkable patient experience, in every dimension, every ... and Review); Missing Guarantor. Resolves work queue errors & denials through research and analysis by reviewing chart and...in charge capture when necessary. Why Novant Health? + Clinical Ladder Program to help you advance your nursing… more
- Highmark Health (Raleigh, NC)
- …workflow within the department. + Prioritize requests for drug authorizations or denials . + Review of prior authorization criteria for drug products. + Recommend ... obtain necessary and/or additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as necessary. + Document all… more
- Intermountain Health (Raleigh, NC)
- … provides advanced training to hospital coding staff, compliance, CDI, physicians, and clinical staff. This Coordinator serves as a subject matter expert for ... audit and monitor all areas of hospital coding. The coordinator works with providers and clinical staff...Audits and creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding review, audit… more