- Stanford Health Care (Palo Alto, CA)
- …and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding professionals, and ... Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials. This position...required within 180 Days or + CCS - Certified Coding Specialist required within 180 Days or… more
- Stony Brook University (East Setauket, NY)
- …coding issue. Audits. + Follow-up on rejected or denied claims, improper payments and coding issues. + Process appeals . + Liaise with third party billing and ... Revenue Specialist **Position Summary** At Stony Brook Medicine, a...functions including but not limited to: billing, claims analysis appeals , follow-up, financial assistance and customer service. **Duties of… more
- Emanate Health (Covina, CA)
- …in the United States, and the #19 ranked company in the country. The Denial Specialist is responsible for denial and AR management as defined by Denial Manager. The ... Denial Specialist will possess and apply thorough knowledge of collections...patient account that is involved in the audit and appeals process to accurately complete accounts receivable reconciliation. **Minimum… more
- Commonwealth Care Alliance (Boston, MA)
- …provider community. In this highly visible field position, the provider relations specialist acts as the primary liaison between CCA and its providers including ... Referral and authorization; Regulatory compliance; Billing and payments; Complaints and appeals ; Policies and procedures. + Identify opportunities for training and… 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
- 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
- Cognizant (Lansing, MI)
- **Member Appeals & Grievances Specialist ** (remote) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** We ... are seeking a dedicated Member Appeals & Grievance Specialist with a minimum...managed care plans or directly with CMS Billing and Coding -Medical Insurance Knowledge of Member/Provider Appeals and… 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
- University of Michigan (Ann Arbor, MI)
- …Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and Appeals Specialist has a strong knowledge of medical appeal and audit ... They are knowledgeable about insurance requirements and medical billing practices. The Appeals Specialist will collaborate with multiple departments to maintain… 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
