- Centene Corporation (Salem, OR)
- …analyze and report verbal and written information regarding member and provider clinical appeals , including information follow up + Prepare response letters ... for member and provider clinical appeals and ensure letters are compliant with State and NCQA standards. + Maintain files and logs for all appeals +… more
- Community Health Systems (Franklin, TN)
- …reduce future denials, and ensure compliance with payer guidelines. As a Denial Appeals Coordinator at Community Health Systems (CHS) - PCCM, you'll play ... **Job Summary** The Denial Coordinator is responsible for reviewing, tracking, and resolving...reviewing, tracking, and resolving denied claims, ensuring that appropriate appeals are submitted, and working closely with payers, internal… more
- CVS Health (Sacramento, CA)
- …issues and may require coordination of responses from multiple business units. Appeals are typically more complex and may require outreach and deviation from ... contact with outside plan sponsors or regulators. Research and resolves Fast Track Appeals as appropriate. Can identify and reroute inappropriate work items that do… more
- Nuvance Health (Danbury, CT)
- …5-9pm- Rotate Weekends/Evenings* *Summary:* Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician ... and facilitates communications with the System Business Office related to appeals , denial and clinical reviews 9. Reviews new denials and appeal upheld cases in… more
- Providence (Beaverton, OR)
- …the best people, we must empower them.** **Providence Health Plan is calling a Clinical Program Coordinator RN, Medicare / Medicaid who will:** + Provide care ... + Oregon **Required qualifications for this position include:** + 5+ years clinical nursing experience + Experience working with physicians in the collaboration and… more
- Elderwood (Amherst, NY)
- …handles Third Party appeals , peer to peers as applicable and with clinical oversight provided by the LPN/RN MDS Coordinator . Attends team meetings at ... Salary Pay: $18.50 - $23.07 / Hour Overview Managed Care Coordinator Overview The Managed Care Coordinator assists and supports the LPN/RN MDS Coordinator … more
- Genesis Healthcare (FL)
- …plans to Full-Time and Part-Time team members. + **Support for New Grads & Clinical Fellows:** Our Powerback Clinical Mentorship Program kicks off on day one, ... Clinicians in Action professional development program. Responsibilities The Reimbursement Coordinator assists the Powerback denial management team gathering records… more
- Community Health Systems (Antioch, TN)
- **Job Summary** The Denial Coordinator is responsible for reviewing, tracking, and resolving denied claims, ensuring that appropriate appeals are submitted, and ... Hyland, BARRT, and other host systems, ensuring timely follow-up on denials and appeals . + Conducts follow-up calls and payer portal research to track the status… more
- HCA Healthcare (Manchester, NH)
- …care like family! Jump-start your career as a Medical Staff Services Coordinator today with Catholic Medical Center. **Benefits** Catholic Medical Center, offers a ... Come join our team as a Medical Staff Services Coordinator . We care for our community! Just last year,...play a key role in the integration of HCA Clinical Strategies and HCA systems. 1. Medical Staff Administration… more
- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** The Transplant Financial Coordinator plays an integral role in assisting patients with the critical function ... billing compliance. The primary responsibility of the Transplant Financial Coordinator is assessing patient's insurance coverage and financial situation for… more