- 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
- Vanderbilt University Medical Center (Nashville, TN)
- …through preeminent programs in patient care, education, and research. **Organization:** Coding and Auth. Appeals **Job Summary:** Coordinates the billing ... people of equal rank in an effort to accomplish team goals. + Coding Knowledge (Intermediate): Ability to assign and interpret ICD-10-CM/PCS coding … more
- TEKsystems (Houston, TX)
- …this is not the simple call - this is a follow up that's been re-routed to the appeals specialist to do in the depth review of the denial letter to determine the ... revenue cycle appeal, revenue cycle specialist , denials specialist , appeals specialist , insurance follow...appeal to payer, review claims to find errors in coding + billing - root cause analysis is critical… more
- TEKsystems (Portland, OR)
- Professional Summary: The Appeals Specialist I is responsible for managing provider billing disputes and appeals with precision and professionalism. This ... While not responsible for making final clinical decisions, the Appeals Specialist I works closely with licensed...Outlook. + Strong knowledge of medical terminology, anatomy, and coding (CPT, DX, HCPCs). + Familiarity with Regence claims… more
- Northwell Health (Melville, NY)
- …as a resource for the Health System. Reviews denial trends and identifies coding issues and knowledge gaps. Job Responsibility Serves as liaison between the patient ... current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness… 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
- Houston Methodist (Houston, TX)
- …& Denials Specialist is responsible for coordinating and monitoring the coding -specific clinical charges and denial management and appeals process in a ... and functions as clinical subject matter expert related to coding denials and appeals . **PEOPLE ESSENTIAL FUNCTIONS**...one of the following: + * CCS - Certified Coding Specialist (AHIMA) + * CPC -… more
- Independent Health (Buffalo, NY)
- …a culture that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding ... They will aid in training other team members, evaluating appeals , and share audit trends across the team. Expertise...and audit tips across the team. The Clinical & Coding Specialist -Senior will support the leadership in… more
- Molina Healthcare (Omaha, NE)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals… more
- HCA Healthcare (El Paso, TX)
- …and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts ... want to join an organization that invests in you as an Inpatient Coding Denials Specialist ? At Parallon, you come first. HCA Healthcare has committed up to $300… more