- 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 retrospectively reviews patient medical records, claims ... or AMA CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support… more
- 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
- University of Michigan (Ann Arbor, MI)
- Denials Prevention/ Appeals Specialist Apply Now **Job Summary** The Denials Prevention and Appeals Specialist is responsible for ensuring the accuracy ... and integrity of coding and billing processes within Michigan Medicine. This position...**Job Detail** **Job Opening ID** 266022 **Working Title** Denials Prevention/ Appeals Specialist **Job Title** Medical Coder Compliance… 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
- TEKsystems (Tampa, FL)
- …accurate and timely review, processing and payment of bills to include pre- coding accuracy and adjudication of appeals /provider reconsideration requests. * ... itemized billings for excessive charges, duplications, and appropriate medical bills coding * Reviews/processes appeals and initiates refund requests, assists… more
- Intermountain Health (Washington, DC)
- **Job Description:** The RCO Appeals Specialist is responsible for researching and appealing denied medical claims. Responsible to proactively identify insurance ... Physician Advisor and works with them to obtain support for appeals . + Collaborates with Care Management, Physician Advisors, Revenue Integrity, Compliance,… more
- Elevance Health (Irving, TX)
- …our specialty pharmacies, our infusion centers, and the home setting._ **Referral Specialist II/Patient Access (Pre & Prior Authorizations, Appeals , Insurance) - ... weeks/30 days at the Plano, TX office. The **Referral Specialist II** is responsible for providing support to a...necessary. + Ability to initiate pre-determination, prior authorizations, and appeals for denials based on payer policy. + Ability… more
- St. Luke's Health System (Twin Falls, ID)
- …place to work. **What You Can Expect:** Under limited supervision, the Clinical Appeals Specialist , is responsible for managing client medical denials by ... as necessary. + Acts as a resource to the verifiers on documentation, coding & clinical account review. + Maintains knowledge of state and federal guidelines,… more
- St. Mary's Healthcare (Amsterdam, NY)
- …experience and other factors permitted by law. Responsibilities: * Uses clinical and coding knowledge to ensure accurate and compliant charge items and to recognize ... and audit requests and coordinates attempts to overturn denials by drafting appeals , negotiating with payers, or following up with payer utilization review… more
- Hartford HealthCare (Farmington, CT)
- …Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS),and/or Certified Clinical Documentation ... . Prepare, document, and submit appeals for DRG denials, ensuring appeals are well-supported with clinical evidence, coding guidelines, and regulatory… more
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