- Penn Medicine (East Petersburg, PA)
- …with appropriate documentation. + Ensures that all activities related to denials management functions meet department requirements, maximize revenue collection, ... are met in an appropriate manner. Responsibilities: + Analyzes and researches denials and follows-up with the appropriate payor, practice, and/or patient to resolve… more
- Datavant (Harrisburg, PA)
- …realize our bold vision for healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of ... Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient admission. Experience with...as it relates to job function as delegated by management Ideal candidate should be a Licensed Practical Nurse… more
- Commonwealth of Pennsylvania (PA)
- Drug & Alcohol Case Management Specialist (Local Government) - Delaware County D&A Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5144215) ... Apply Drug & Alcohol Case Management Specialist (Local Government) - Delaware County...compiling discharge plans. Work also involves processing authorizations or denials , addressing inquires from providers and individuals seeking services,… more
- UPMC (Pittsburgh, PA)
- UPMC is seeking to hire a Certified Coding Specialist I to join our Coding Department. This is a work-from-home position, working Monday through Friday during ... five years of coding experience. As a Certified Coding Specialist I, you will have the same responsibilities as...and existing staff. Specifically, you will be working on denials , special projects in targeted specialties to assist in… more
- WellSpan Health (Chambersburg, PA)
- …identification and investigation of issues related to precertification, reimbursement, denials , insurance availability, etc., and promptly notifies physician. + ... and accurately documents actions/communication surrounding discharge planning and/or utilization management in the medical record. + (BHU Only) Incorporates recovery… more
- UPMC (Pittsburgh, PA)
- …the area of authorization related activities including pre-authorizations, notifications, edits, denials , etc. The Authorization Specialist shall demonstrate the ... UPMC Digestive Health Care is hiring a full-time Authorization Specialist to join their team at Shadyside Medical Building, Pittsburgh! In this position, you will… 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...for the position. Essential Functions: 1. Identifies and evaluates denials for assigned payers and/or specialties to determine specific… more
- UPMC (Pittsburgh, PA)
- …claims for the WorkPartners Workers Compensation business unit. The Lost Time Claims Specialist II will apply litigation management skills to aggressively manage ... UPMC WorkPartners is hiring a full-time Lost Time Claims Specialist II! This role will predominantly work remotely, Monday - Friday daylight hours. The selected… more
- St. Luke's University Health Network (Allentown, PA)
- …patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... of diagnosis and procedure code assignment and MS-DRG/APR-DRG accuracy based on denials or audit findings from government and commercial payers. Meet or exceed… more
- Philips (Malvern, PA)
- …or Reimbursement Services. + Your skills include: + Experience with denial management , claim follow up, overturning denials and identifying payer issue ... + Working with various commercial insurnace payers to resolve claims and denials . + Escalating payor issue trends for leaderships consideration along with possible… more