- Community Health Systems (Fort Smith, AR)
- **Job Summary** Responsible for managing appeals and denials staff in processing accounts and working with designated payors to ensure proper reimbursement, maximize ... in achieving payment resolution and, in identifying trends of denials seen to prevent ongoing losses. + Monitors collection...and procedures required + 3-6 years Related experience in denials and appeals required + 2-4 years Supervisory experience… more
- Mayo Clinic (Rochester, MN)
- …Competitive retirement package to secure your future. **Responsibilities** The **Senior Manager - Denials Management Operations** plays a critical leadership ... can build a long, successful career with Mayo Clinic. **Benefits Highlights** + Medical : Multiple plan options. + Dental: Delta Dental or reimbursement account for… more
- CenterWell (Atlanta, GA)
- …help us put health first** **This is a hybrid position; 1 day in office/4 days remote . Must live in either the Atlanta, GA market or Kansas City, MO or Kansas City, ... KS markets.** As the **RCM Manager ** , you will: + Manage the collection and...+ Career development opportunities Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- CenterWell (Topeka, KS)
- …community and help us put health first** As an **RCM Healthcare Claims Denials Specialist/Accounts Receivable Specialist** , you will: + Ensure the coordination of ... + High School Diploma or the equivalent + Minimum of two years medical claims processing experience + Knowledge of healthcare collection procedures and microcomputer… more
- RWJBarnabas Health (Oceanport, NJ)
- Manager , Appeals (Full- Time) Remote RoleReq #:0000200495 Category:Billing/Collections/Registration Status:Full-Time Shift:Day Facility:RWJBarnabas Health ... of steps to prevent future avoidable denials . + Research payer denials related to referral, pre-authorization and medical necessity. + Validate denial… more
- Insight Global (Minnetonka, MN)
- … necessity criteria for all Commercial PPO patients would result in reduction of denials Increased UR nurse review against medical necessity criteria within 24 ... in progress. This will inform tactics. RCI Throughput - Denials / UM: There is an opportunity to reduce...There is an opportunity to reduce Commercial PPO inpatient medical necessity denial rate by requiring physician review of… more
- Ochsner Health (New Orleans, LA)
- …specific care setting order by the physician and applies hospital approved medical necessity criteria to review appropriate admissions and levels of care. Documents ... license in state of practice. Preferred - Commission for Case Manager (CCM), Certified Professional Utilization Review (CPUR), Certified Professional in Utilization… more
- Community Health Systems (Sarasota, FL)
- …claims management systems to review, correct, and resolve billing errors, denials , and rejections. The Billing Specialist I collaborates with internal teams, ... we serve. Our team members enjoy a robust benefits package including medical insurance, dental insurance, vision insurance, PTO, 401K, sick time, holidays, and… more
- Methodist Health System (Dallas, TX)
- …Of Week :** Mon-Fri **Work Shift :** **Job Description :** Your Job: The Manager of Collections Physician Billing is responsible for overseeing the AR follow up team ... drive performance improvements and meet departmental and organizational goals. The Manager will work closely with various internal and external departments,… more
- TEKsystems (Sarasota, FL)
- …entry, medical claim,denied claims,patient access Additional Skills & Qualifications Appeals and denials medical claims medical appeals medical ... Audits, or outpatient appeals and communicates daily with Sr. Director/ Manager on trends identified 2. Respond to queries within...with other projects as needed 5. Submits requests for medical records, ub's, and itemized bills as needed 6.… more