- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Coding Appeals Specialist analyzes patient medical records, claims data and ... MS-DRG for the purposes of appealing proposed MS-DRG and coding changes by insurance providers or their auditors. Assures...provide feedback, including identification of trends, to the Network Coding and CDMP Managers for education of the medical… more
- Oracle (Harrisburg, PA)
- …this exciting arena. We are looking for a Senior Claims Denial Prevention and Appeals Specialist for providing clinical inputs to engineering for developing the ... clinical and reimbursement tasks such as charting, documentation, and coding by applying power of generative AI. Our diverse...Claim Denial Prevention and Appeals features of Oracle Health Clinical AI Agent (CAA).… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and ... formal meetings with auditor or payor representatives in defense of coding appeals , as needed. + Maintain necessary audit/appeal activity documents including… more
- Globus Medical, Inc. (Collegeville, PA)
- …Summary** **:** Reporting to the Supervisor, Patient Access, the Patient Access Specialist will focus on providing payer coverage support to customers from the ... initial processing of received documentation through prior authorization, appeals support, detailed claims review, and hotline support. The Patient Access … more
- Guthrie (Sayre, PA)
- Position Summary: Fulfills all requirements of Insurance Specialist I, as well as serving as a group leader by participating in staffing and employment issues. ... Serves as a resource specialist within the department. Trains Insurance Billing Specialists I...to complete all types of complex insurance billings and appeals . Reviews and analyzes the insurance processing procedures to… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Accounts Receivable Specialist I is responsible for the billing and collection of the accounts receivable ... practitioner services for the St. Luke's Physician Group. The Accounts Receivable Specialist I is responsible for accurate and timely submission of claims to… more
- Penn Medicine (East Petersburg, PA)
- …future each day. Are you living your life's work? Job: Denials Management Specialist Hours: Day shift hours, start time between 07:00am-9:00am (8 hour shifts) ... to expedite the resolution of the denied claim. + Performs all appeals and denial recovery procedures needed to appropriately and accurately resolve denied… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …than the sum of its parts. Join our dynamic team as a Benefits Investigation Specialist and be a crucial part of ensuring access to essential medications! We seek a ... interactions. + Keeps up to date with reimbursement process, billing/ coding nuances, insurance plans, payer trends, financial assistance programs, charitable… more