- R1 RCM (Boise, ID)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals and Denials Manager ** , you will serve as an ... denial management. **Here's what you will experience working as a Clinical Appeals & Denials Manager :** + Serve as a leader and mentor to Clinical … more
- TEKsystems (Austin, TX)
- Description: Job Summary: The Revenue Cycle Denials and Appeals Specialist will be responsible for building and maintaining collaborative and productive ... of knowledge for the designated revenue cycle function, with a focus on Denials and Appeals * Performs analysis, identifies trends, presents opportunity areas,… more
- Dayton Children's Hospital (Dayton, OH)
- …Home - OhioDepartment:Utilization Review TeamSchedule:Full timeHours:40Job Details:Reporting to the Manager of Utilization Management and in partnership with the ... and Resource Management; supports the development and implementation of a comprehensive denials management program. This role functions as a hospital liaison with… more
- Hartford HealthCare (Farmington, CT)
- …works collaboratively with appropriate teams to prevent future denial. . Coordinates clinical appeals process and participates in compliance investigations as ... as needed to determine the appropriate course of denial appeals . . Maintains accurate, clear, timely documentation related to...Works with and provides education to HHC staff on denials issues related to reimbursement, clinical criteria,… more
- Guidehouse (Birmingham, AL)
- …Companies to resolve claim denials and account balances. + Performing Non- Clinical Appeals . + Assisting Supervisor/ Manager as needed with various ... expert can effectively resolve the matter. + Communicate to Supervisor/ Manager areas of concern or areas of improvement. +...+ 0-2 years medical provider experience working with UB04, appeals & denials . **What Would Be Nice… more
- St. Luke's University Health Network (Allentown, PA)
- …to, physicians, hospital employees and vendors. Advises Network CDI & DRG Denials Manager on issues requiring immediate attention. ADDITIONAL REQUIREMENTS: ... regardless of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of… more
- Houston Methodist (Houston, TX)
- …services. This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in ... Supervisor. + Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further...queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits… more
- UNC Health Care (Chapel Hill, NC)
- …to coder questions and provide training and education. This position processes and appeals insurance coding denials . This position analyzes coded records for ... and ancillary cases). 3. Faxes, tracks, and monitors coding denials and appeals on both inpatient and...on both inpatient and outpatient cases. Reviews coding insurance denials and refers clinical coding denials… more
- Priority Health Care (Marrero, LA)
- …AR work lists provided by the manager in a timely manner. + Write appeals using established guidelines to resolve claim denials with a goal of one contact ... also involves ensuring timely response from third-party payors, processing payor denials , documentation requests, and appeals , and monitoring day-to-day… more
- Houston Methodist (Houston, TX)
- …verbal and written communication. + Identifies denial trends and notifies supervisor and/or manager to prevent future denials and further delay in payments. ... services. This position performs collections activities on simple and complex denials and on outstanding insurance balances in the professional fee environment.… more